Effect of Home‐Based Exercise and Influence of Training Principles on Cardiorespiratory Fitness in Sedentary Healthy People and Patients With Cardiovascular Disease: A Systematic Review With Meta‐Analysis

ABSTRACT The effectiveness of home‐based exercise programmes may vary depending on compliance to exercise training principles. Therefore, the aim of this review was to investigate the effect of unsupervised home‐based exercise programmes on cardiorespiratory fitness (CRF) in healthy sedentary individuals and patients with cardiovascular disease (CVD) taking into account the influence of exercise training principles. PubMed, Embase and Web of Science were searched up to July 2025. Controlled studies that performed a home‐based aerobic training or combined training, and directly measured peak oxygen uptake (VO 2 peak) were included. The mean difference (MD) with its 95% confidence interval (CI) was used as the effect size index. Random‐effects models were used to conduct pooled analyses. Heterogeneity analyses were performed using the chi‐square test and the I 2 index. The results showed an improvement in the VO 2 peak in the intervention group compared to the control group (MD = 2.70 mL·kg −1 ·min −1 CI = 1.78, 3.62 p < 0.001), with no difference between healthy participants and patients with CVD. Heterogeneity tests reached statistical significance ( p < 0.001), and inconsistency was high ( I 2 = 85%). We found a greater improvement in VO 2 peak in favour of the intervention group in those studies that met the overload principle and in those which used the ventilatory threshold‐based method for determining aerobic training intensity in healthy sedentary people and patients with CVD. Overload and individualisation principles should be considered for increasing the effect of unsupervised home‐based exercise training on VO 2 peak. Trial Registration The study protocol was prospectively registered in the PROSPERO database (CRD42024516257)