Meta-analysis finds home-based exercise improves VO2 peak in CVD and healthy adults
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Key Takeaway
Consider home-based exercise to improve VO2 peak, but high heterogeneity limits certainty.
This systematic review with meta-analysis evaluated the effect of unsupervised home-based exercise programmes (aerobic or combined training) on cardiorespiratory fitness in healthy sedentary individuals and patients with cardiovascular disease. The primary outcome was peak oxygen uptake (VO₂ peak). The meta-analysis pooled data from studies comparing home-based exercise to a control group.
The main finding was a statistically significant improvement in VO₂ peak favoring the intervention group (mean difference = 2.70 mL·kg·min; 95% CI = 1.78 to 3.62; p < 0.001). However, the authors noted significant heterogeneity across studies (I² = 85%; p < 0.001), indicating substantial variability in effect sizes that could not be explained by the analysis.
Limitations of this meta-analysis include high inconsistency among studies, which reduces confidence in the pooled estimate. Additionally, details such as sample sizes, follow-up duration, and adverse events were not reported in the abstract, limiting the ability to assess safety or generalizability. The authors did not report funding or conflicts of interest.
For clinical practice, the findings suggest that unsupervised home-based exercise can improve cardiorespiratory fitness, but the high heterogeneity implies that individual responses may vary. The authors recommend considering overload and individualisation principles to enhance the effect. Clinicians should interpret these results cautiously and recognize that the optimal exercise prescription remains unclear.
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View Original 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 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 index. The results showed an improvement in the VO peak in the intervention group compared to the control group (MD = 2.70 mL·kg·min [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 = 85%). We found a greater improvement in VO 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 peak. TRIAL REGISTRATION: The study protocol was prospectively registered in the PROSPERO database (CRD42024516257).
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