title: Effect of combined aerobic and resistance training versus aerobic training alone in individuals with coronary artery disease: a meta-analysis.
abstract: BACKGROUND
  Resistance training (RT) has only a permissive role as an adjunct to aerobic training (AT) in cardiac rehabilitation.
  
  
  METHODS
  To compare the effect of AT with combined RT and AT (CT) we searched MEDLINE, Cochrane Controlled Trials Register, EMBASE, PreMedline, SPORT DISCUS, CINAHL (from the earliest date available to October 2009) for randomized controlled trials (RCTs), examining effects of CT versus AT on body composition, cardiovascular fitness (VO(2peak)), strength, and quality-of-life (QOL) in coronary artery disease (CAD) (excluding heart failure). Two reviewers selected studies independently.
  
  
  RESULTS
  Twelve studies met the study criteria (229 AT patients, 275 CT patients). Compared with AT, CT decreased percent body fat by -2.3% (WMD (weighted mean difference); 95% CI: -3.59 to -1.02), decreased trunk fat (SMD (standardized mean difference): -0.56; 95% CI: -0.96 to -0.15) and increased fat-free mass by 0.9 kg (WMD; 95% CI: 0.39 to 1.36) in three studies (n = 106). Similarly CT was associated with larger increases in lower body strength (seven studies, n = 225, SMD: 0.77; 95% CI: 0.49 to 1.04) and upper body strength (eight studies, n = 262, SMD: 1.07; 95% CI: 0.76 to 1.38). Compared to AT, CT improved peak work capacity (three studies, n = 92, SMD: 0.88; 95% CI: 0.45 to 1.31) and there was a trend for CT to increase VO(2peak) by 0.41 ml/kg/min (nine studies, n = 399, WMD; 95% CI: -0.05 to 0.88). Qualitative analysis of QOL data favors CT. Study withdrawals were similar for AT (14.2% ± 13.2) and CT (11.5% ± 15.5). No serious adverse events were reported.
  
  
  CONCLUSIONS
  CT is more effective than AT in improving body composition, strength, and some indicators of cardiovascular fitness, and does not compromise study completion or safety when compared to AT.
authors: Toronto Rehabilitation Institute, Toronto, Canada. Marzolini.susan@torontorehab.on.ca
authors: Susan
authors: S
authors: Marzolini
authors: Paul I
authors: PI
authors: Oh
authors: Dina
authors: D
authors: Brooks
mesh_terms: D000368:Aged; D001823:Body Composition; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000534:rehabilitation*; D019317:Evidence-Based Medicine; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010809:Physical Fitness; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D055070:Resistance Training; D016896:Treatment Outcome