A study led by Tasuku Terada and published online on March 23, 2026, in the Journal of Sport and Health Science found that combining aerobic and muscle strength training can improve outcomes for people with heart failure. The research compared the effects of combined training to aerobic training alone in patients with different types of heart failure.
Heart failure affects over 64 million people worldwide and is expected to become more common. It is a serious condition that reduces exercise tolerance, quality of life, and increases the risk of hospitalization. There are two main types: heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF).
The researchers systematically reviewed studies comparing combined training to aerobic-only programs. Of nearly 14,000 studies screened, they included data from 15 studies involving mostly male patients—466 with HFrEF and 60 with HFpEF. The analysis showed that for those with HFrEF, combined training improved aerobic fitness, walking distance, and upper body muscle strength more than aerobic exercise alone. These benefits remained even when total exercise time was matched between groups.
No significant differences were seen between groups for lower body muscle strength or health-related quality of life. Adherence rates were high or similar between both types of programs; dropout rates and adverse events were also comparable.
The findings suggest that allocating time to both aerobic activity and muscle strengthening may be a better strategy for improving key measures related to prognosis in HFrEF patients than focusing on aerobic activity alone. Combining high-intensity interval training (HIIT) with muscle strength work could also offer a time-efficient approach to boosting fitness levels.
Researchers said further evidence is needed to determine if these results apply equally to those living with HFpEF.
