A stronger heart-rehabilitation program includes the rest of the body

THE ARISING · 20 OCTOBER 2026 · FULL ARTICLE

Heart rehabilitation has long centered on aerobic exercise such as walking or cycling. A systematic review in Sports Medicine–Open asks what happens when resistance training joins it. The answer points toward a broader view of recovery: fitness, strength and the ability to do more in daily life.

Gois and colleagues gathered 61 randomized controlled trials involving 5,388 randomized participants with coronary heart disease. The trials compared combined aerobic and resistance training with aerobic training alone, resistance training alone, usual care without exercise, or other combined programs. Different comparisons answer different questions and should not be treated as interchangeable.

What improved

Compared with non-exercising usual care, combined training improved peak oxygen consumption, strength measures and health-related quality of life. Peak oxygen consumption rose by an average of 2.20 milliliters per kilogram per minute. This is a measure of exercise capacity, not a direct measure of years of life gained.

The comparison with aerobic training alone is especially relevant to existing rehabilitation programs. Combined training generally performed better on oxygen uptake, six-minute walking distance, several measures of muscle strength and quality of life. The pooled difference in six-minute walking distance was about 22 meters.

Against resistance training alone, the combined approach also improved peak oxygen consumption. Together, the findings suggest that aerobic and strength work can contribute complementary benefits rather than requiring an either-or choice.

Read the mortality claim carefully

The review reported fewer mortality events with combined training than with non-exercising usual care. That comparison does not isolate the effect of adding strength work to an aerobic program. It should not be turned into a claim that a particular lifting routine prevents death or extends an individual's lifespan.

The trials varied in their programs, participants and follow-up. Many programs were relatively short, and women were underrepresented. Supervised rehabilitation also differs from attempting a new program alone after a cardiac event. The review cannot settle the safest or most effective mix for every patient.

The useful question

For someone entering cardiac rehabilitation, a practical conversation is whether the program develops both aerobic capacity and strength, and how the team adapts those elements to their condition. Exercise after a heart event belongs within an individualized rehabilitation plan.

The larger longevity idea is straightforward. Recovery is about more than a test result. Walking farther, carrying something comfortably and feeling capable in the world are outcomes worth measuring. Longer follow-up will help show how durable the gains are and which program designs deliver them most safely.