A Review of Concurrent Training Versus Moderate Intensity Continuous Training Cardiac Rehabilitation Modalities

Abstract

Moderate intensity continuous training (MICT) is the standard for exercise-based cardiac rehabilitation (CR) of patients with coronary artery disease (CAD). Traditionally, resistance training has been used as an adjunctive modality; however, new evidence suggests aerobic exercise and resistance training are complementary, a combined approach called concurrent training (CT). The present review analyzed emergent scientific evidence of programmatic efficacy of CT vs MICT. Analyses focused on five primary outcomes: aerobic capacity, cardiovascular performance, cardiovascular disease (CVD) risk factors, recurrent cardiac events, and psychosocial changes. A PubMed search for eligible studies used Boolean phrases that included both sexes, CAD, MICT and CT treatment groups, 18-to-36 CR sessions, and both pre-post program measurements from two or more outcome categories. Sixteen investigations met eligibility criteria, and findings indicated strength gains with CT exceeded those of traditional MICT programming. Separately, patients assigned to CT demonstrated similar changes in VO₂peak, peak heart rate, and body composition as MICT. Despite reduced time spent on the moderate intensity aerobic exercise component, patients assigned to CT had similar improvements in VO₂peak as compared with MICT. Both exercise formats demonstrated comparable adherence rates, whereas collective patient hours of observed CT were insufficient to draw conclusions regarding safety or adverse events.