Optimizing Training Response for Women in Cardiac Rehabilitation

Quick Takes

  • High-intensity interval training combined with lower-extremity resistance training improved peak VO2 to a greater degree than standard moderate-intensity training among women enrolled in cardiac rehabilitation.
  • Improvements in leg strength were also noted for women randomized to high-intensity interval training plus intensive lower-extremity resistance training.

Study Questions:

Does high-intensity interval training (HIIT) and intensive lower-extremity resistance training (RT) improve peak oxygen uptake (peak VO2) compared to standard moderate-intensity continuous training (MCT) among women participants in cardiac rehabilitation (CR)?


Data from a randomized clinical trial conducted from July 2017–February 2020 were used for the present analysis. Women enrolled in a community-based CR program comprised the study population. The interventions compared were MCT (70-85% of peak heart rate [HR]), with moderate intensive RT or HIIT (90-95% of peak HR) along with higher-intensity lower-extremity RT 3 times per week over 12 weeks. The primary outcome of interest was a change in peak VO2 (L/min) from baseline to 12 weeks.


A total of 56 women (mean age 65 ± 11 years, range 43-98 years) participating in CR were included in the present analysis. Peak VO2 increased to a greater degree in the HIIT group (+23%) than in the control group (+7%) (mean [SD] increase, 0.3 [0.2] L/min vs. 0.1 [0.2] L/min; p = 0.03). Similarly, the change in leg strength was greater in the HIIT+RT group compared with the control group (mean [SD] increase, 15.3 [0.3] kg vs. 6.4 [1.1] kg; p = 0.004).


The investigators concluded that an exercise protocol that combined HIIT and intensive lower-extremity RT resulted in more significant improvement in peak VO2 among women enrolled in CR, compared to standard CR exercise training.


These data suggest that HITT and RT may be of more benefit for women enrolled in CR. In addition to increases in peak VO2, improvements in leg strength were also noted. However, further study in larger and more diverse populations is warranted.

Clinical Topics: Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Prevention, Sports and Exercise Cardiology, Exercise

Keywords: Cardiac Rehabilitation, Exercise, Exercise Therapy, Heart Rate, High-Intensity Interval Training, Life Style, Physical Therapy Modalities, Primary Prevention, Resistance Training

< Back to Listings