Effectiveness and selection of exercise prescriptions for myocardial infarction patients: a systematic review and meta-analysis

Background: Exercise intervention has garnered significant attention for its potential to promote recovery and improve outcomes in myocardial infarction (MI) patients. However, controversy persists regarding the efficacy of exercise prescriptions in related studies. Therefore, this research aims to analyze the effects of exercise prescriptions during MI rehabilitation and associated influencing factors through systematic review and meta-analysis, thereby providing guidance for exercise prescription selection in MI patients. Methods: A systematic review and meta-analysis were conducted by retrieving data from PubMed, Web of Science, and Scopus databases between January 2015 and June 2025. Only meta-analyses using random-effects models for cardiac function were included in the study. Subgroup analyses were conducted based on exercise type, intensity, session duration, frequency, and intervention duration. Results: A total of 42 studies were included. The results showed that exercise intervention significantly improves cardiac function, exercise performance, and quality of life in MI patients, while significantly reducing the incidence of adverse cardiovascular events. A subgroup analysis of 26 cardiac function studies revealed that variations in exercise type, intensity, frequency, session duration, and intervention duration all exerted modulatory effects on left ventricular ejection fraction (LVEF) levels in MI patients. However, the certainty of evidence related to LVEF is generally low, and the pooled effect is mainly influenced by non-randomized studies with high risk of bias. Furthermore, the evidence is subject to inconsistency and/or imprecision, leading to a potential low or very low certainty in conclusions. Conclusion: Current findings indicate that moderate-intensity aerobic or resistance training, with each session lasting < 30 min, < 3 times per week, and an intervention duration > 16 weeks, is more beneficial for the rehabilitation of MI patients. The clinical research on resistance training is currently insufficient, and some studies have a high risk of bias. Additionally, there is considerable heterogeneity in the heart function intervention methods (e.g., type, session duration, frequency, intensity, and intervention duration), which could potentially influence the research outcomes. Therefore, more high-quality studies are needed in the future to validate these findings and provide more reliable scientific evidence for optimizing rehabilitation strategies for MI patients. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251085069, PROSPERO CRD420251085069.