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Combined endurance and resistance exercise improves peak oxygen consumption and quality of life in heart failureExercise Training Improves Heart Failure Outcomes

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Key Takeaway
Consider combined endurance and resistance exercise to improve physical capacity and quality of life in heart failure.

This meta-analysis synthesized findings from 9 studies to evaluate the impact of combined endurance and resistance exercise training on patients with heart failure. The analysis focused on key indicators of physical capacity and patient well-being.

The pooled results showed significant improvements in several secondary outcomes for the intervention group compared to controls. Specifically, peak oxygen consumption showed a mean difference (MD) of 4.36 (95% CI: 1.68 to 7.04, P = 0.001). Quality of life scores improved with an MD of -9.32 (95% CI: -16.92 to -1.71, P = 0.02). Additionally, the six-minute walk test showed a significant improvement with an MD of 53.76 (95% CI: 38.81 to 68.70).

While the meta-analysis suggests that combined exercise modalities may enhance functional capacity and quality of life in heart failure patients, specific safety data, including adverse events or tolerability, were not reported. The evidence is based on a pool of 9 studies; however, individual study limitations were not detailed.

How this fits prior evidence

This meta-analysis addresses gaps in non-pharmacological management for heart failure patients. While prior coverage noted that an immune-stromal imbalance drives heart failure after myocardial infarction and that engineered extracellular vesicles show potential for cardiac repair, this finding focuses on physical rehabilitation. It complements existing evidence by highlighting the role of combined endurance and resistance training in improving functional outcomes like peak oxygen consumption (MD = 4.36) and six-minute walk test performance (MD = 53.76).

A new meta-analysis of nine studies found that combining endurance and resistance exercise training significantly improves key outcomes for people with heart failure. The analysis looked at how this type of exercise affected peak oxygen consumption, quality of life, and the six-minute walk test.

Patients who did combined exercise training showed a significantly greater improvement in peak oxygen consumption compared to a control group. The average difference was 4.36 units, with a 95% confidence interval of 1.68 to 7.04. Quality of life also improved significantly, with an average difference of -9.32 units (95% CI: -16.92 to -1.71). The six-minute walk test distance increased by an average of 53.76 meters (95% CI: 38.81 to 68.70).

No safety information, such as adverse events or discontinuations, was reported in the analysis. The study is a meta-analysis, meaning results are pooled from multiple studies, which can strengthen the evidence but also depends on the quality of the included studies.

For people with heart failure, this analysis suggests that a combined endurance and resistance exercise program may offer meaningful benefits. However, anyone with heart failure should talk to their doctor before starting a new exercise routine to ensure it is safe and appropriate for their condition.

What this means for you:
Combined endurance and resistance exercise may improve oxygen use, quality of life, and walking distance in heart failure.

Common questions

What is combined endurance and resistance exercise training?

It is a type of exercise program that includes both aerobic activities like walking or cycling and strength exercises like lifting weights. This combination aims to improve both cardiovascular fitness and muscle strength.

How much did the six-minute walk test improve?

The six-minute walk test distance improved by an average of 53.76 meters in the exercise group compared to the control group, with a 95% confidence interval of 38.81 to 68.70 meters.

Is this exercise program safe for all heart failure patients?

The meta-analysis did not report any safety information, such as adverse events. It is important for heart failure patients to consult their doctor before starting any new exercise program to ensure it is safe for their specific condition.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
ObjectiveTo evaluate the efficacy of Combined endurance and resistance exercise training in patients with heart failure (HF) and provide an evidence-based foundation for clinical management.MethodsA comprehensive search was conducted across domestic and international databases from inception to November 2025 for studies on Combined endurance and resistance exercise training in HF. Study quality was evaluated using the Cochrane Risk of Bias tool. Literature management was performed using NoteExpress 3.2. Data collection and extraction were conducted with Excel 2003. Statistical analysis was performed using RevMan 5.4.1 software. Heterogeneity was determined via the Q-test (P-value). Accordingly, the pooled effect size was calculated as the mean difference (MD) or odds ratio (OR) using a fixed- or random-effects model. Forest plots were generated, and publication bias was assessed via funnel plots.ResultsNine studies met the inclusion criteria. Meta-analysis results demonstrated that, compared to the control group, the intervention group showed significantly greater improvement in peak oxygen consumption (MD = 4.36, 95% CI: 1.68–7.04, P = 0.001) and quality of life (MD = −9.32, 95% CI: −16.92 to −1.71, P = 0.02). Performance on the six-minute walk test was also significantly better in the intervention group (MD = 53.76, 95% CI: 38.81–68.70, P 
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