Systematic review| Volume 101, ISSUE 4, P690-699, April 2020

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Comparison of Treadmill and Cycle Ergometer Exercise During Cardiac Rehabilitation: A Meta-analysis

Published:November 15, 2019DOI:



      To compare treadmill versus cycling-based exercise in cardiac rehabilitation (CR) on functional capacity (FC) outcomes.

      Data Source

      Databases were searched for randomized studies using single modality continuous exercise.

      Study Selection

      Studies implemented a continuous cycling or treadmill protocol for patients with either coronary artery disease (CAD) or chronic heart failure (CHF). The effect of single modality exercise on FC (VO2peak) was analyzed. Differences in the effect of CR on FC was assessed between the mode subgroup (cycling vs treadmill) and disease state subgroup (CAD vs CHF) within both the cycling and treadmill groups.

      Data Extraction

      Data were extracted from 23 studies including 600 patients (mean age 60y, 86% men).

      Data Synthesis

      There was a significant difference in effect size between studies that used cycling, Hedges’ g=0.85 (95% confidence interval [95% CI], 0.52-1.17; k=13) and studies that used treadmill exercise, Hedges’ g=0.46 (95% CI, 0.22-0.70; k=8). Within cycling studies (n=14), FC was higher among CAD patients, Hedges’ g=1.03 (95% CI, 0.65-1.42; k=9) compared to those with CHF, Hedges’ g=0.40 (95% CI, 0.09-0.71; k=4, P<.001). Conversely, among treadmill studies (n=9), FC was higher among CHF patients, Hedges’ g=0.94 (95% CI, 0.23-1.65; k=2) compared to CAD, Hedges’ g=0.33 (95% CI, 0.19-0.47; k=5; P<.01).


      According to identified studies, when cycling was the primary mode of exercise in CR, there was larger change in FC compared to treadmill exercise. In addition, CAD patients experienced greater gains in FC when cycling was the primary mode of exercise in CR, while CHF patients benefited more from treadmill-based exercise programs.


      List of abbreviations:

      CAD (coronary artery disease), CHF (chronic heart failure), CR (cardiac rehabilitation), FC (functional capacity)
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