What question did this study set out to answer?

This review aims to map the application and outcomes of concurrent training in cardiac rehabilitation for patients with coronary artery disease.

March 8, 2026Open Access

Concurrent training in cardiac rehabilitation: A scoping review of aerobic-strength combinations in patients with coronary artery disease

Key Result

Concurrent training in cardiac rehabilitation improves exercise capacity and muscle strength without reported adverse events, despite wide variability in protocols.

Key Points

This review aims to map the application and outcomes of concurrent training in cardiac rehabilitation for patients with coronary artery disease.
Conducted a systematic search from October 2023 to December 2025.
Included 14 clinical trials comparing concurrent training to usual care or aerobic training alone.
Evaluated variations in training settings, CR phases, program durations, and exercise structures.
Identified diverse training formats and prescriptions across studies.
Physiological outcomes, especially exercise capacity and muscle strength, were consistently assessed.
No adverse events related to concurrent training were reported.

Structured PICO

How is concurrent training designed, delivered, and evaluated in patients with coronary artery disease undergoing cardiac rehabilitation?

Population

1,037 patients with coronary artery disease across 14 clinical trials (13 randomised, 1 single-group)

Intervention

Concurrent training (CT), integrating aerobic and strength exercise modalities within cardiac rehabilitation (phases II-III, duration 5-32 weeks)

Comparator

Usual care or aerobic training alone

Outcome

Design and delivery of CT in CR, and reported outcomes across International Classification of Functioning, Disability and Health (ICF) domains

Concurrent training in cardiac rehabilitation is safe and frequently assesses physiological outcomes, but marked variability in exercise prescription highlights the need for standardized reporting and evaluation of long-term, patient-centered outcomes.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Concurrent training (CT), defined as the integration of aerobic and strength exercise modalities, is increasingly implemented within cardiac rehabilitation (CR) to improve cardiovascular and musculoskeletal health. However, CT prescriptions vary markedly, and the characteristics and application of CT within CR have not been comprehensively mapped. This scoping review examined how CT has been designed and delivered in CR and summarised reported outcomes across International Classification of Functioning, Disability and Health (ICF) domains. A systematic search of databases and supplementary sources was conducted from October 2023 to December 2025. Clinical trials evaluating CT compared with usual care or aerobic training alone were eligible. Fourteen trials (n = 1,037; 13 randomised, 1 single-group) were included. CT programmes varied widely in setting (hospital, community, hybrid), CR phase (II-III), duration (5-32 weeks), and training structure. Aerobic training was delivered using continuous aerobic training (CAT), aerobic interval training (AIT), or high-intensity interval training (HIIT), with intensities prescribed using peak oxygen uptake (V̇O₂peak), maximum heart rate (HRmax), heart rate reserve (HRR), work rate, ventilatory threshold, or rating of perceived exertion (RPE). Modalities ranged from cycle ergometers and treadmills to multimodal or circuit-based formats. Strength-training prescriptions differed in targeted muscle groups, sets (2-8), repetitions (8-20), equipment (e.g., machines, free weights, TheraBand), and intensity anchors (% of one repetition maximum, RPE, % of maximum voluntary contraction). Application of progressive overload was inconsistent across studies. Exercise capacity (primarily V̇O₂peak) and muscle strength were the most consistently assessed outcomes. No CT-related adverse events were reported. CT has been applied using diverse delivery formats and exercise prescriptions within CR. Physiological outcomes were most consistently measured, whereas activity and participation-level outcomes showed greater variability and limited long-term evaluation. Future research should prioritise clearer reporting of training parameters, examine CT within community and hybrid CR models, incorporate behavioural and patient-reported outcomes, and investigate sex-specific responses and long-term effects to inform scalable and contextually adaptable CT approaches.