Circuit Training With and Without Upper and Lower Limb Resistance Training in Post-CABG Patients

March 16, 2026 updated by: Riphah International University

Effects of Circuit Training With and Without Upper and Lower Limb Resistance Training on Paroxysmal Nocturnal Dyspnea, Functional Capacity and Endurance in Post-CABG Patients

This study aims to evaluate the contrasting effects of circuit training with and without upper and lower limb resistance training on paroxysmal nocturnal dyspnea, functional capacity and endurance on post-CABG patients.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

A randomized controlled trial underlined that dynamic strength training dramatically increased peripheral muscular strength and power when combined with endurance training, which may enhance patient prognosis, according to a study done on patients with cardiovascular disease. According to the study, dynamic strength training is therefore advised as a crucial part of cardiovascular rehabilitation. The results showed that strength training was associated with lesser increases in intra-arterial blood pressure and cardiac output, indicating sufficient cardiovascular safety. All things considered, this study questions accepted therapeutic practice and reignites the discussion about the best dynamic strength training. highlighted the importance of lower limb muscle strengthening in an RCT following CABG surgery; Phase II cardiac rehab showed significant gains in lower limb strength and overall physical and cardiorespiratory performance 6 weeks following hospital discharge, as determined by the Short Physical Performance Battery and 6MWT. Although, cardiac rehabilitation following coronary artery bypass graft (CABG), has been shown to increase functional capacity and quality of life. Significant gaps exist in determining the exact exercise prescription for symptom alleviation and functional recovery. Existing researches primarily focused on conventional continuous aerobic training (CAT) or the circuit-based training alone, with little attention on targeted upper and lower limb resistance training in clinical settings. Furthermore, the majority of the literature assesses the outcomes such as peak oxygen uptake (V̇O₂max), six-minute walk distance (6-MWD) or general dyspnea scores. While paroxysmal nocturnal dyspnea is clinically significant and unpleasant condition among post-CABG patients, is understudied. Dyspnea is usually examined using non-specific tools and techniques during rehabilitation programs but a few studies used cardiac-specific symptom classification tools in post-CABG rehabilitation. In addition, there is a lack of randomized clinical trials that investigate combined effects of circuit-resistance training in Phase-II cardiac rehabilitation on multiple domains like dyspnea severity, muscle strength, endurance and functional capacity within a single-structured rehabilitation program. Some studies include small sample sizes or shorter study durations which limit the validity of the findings and the ability to derive clinically significant conclusions. Furthermore, insufficient information is available from low and middle-income nations where patient characteristics and healthcare resources are differ from those in high-income countries. This emphasizes the importance of doing context-specific to help define evidence based cardiac rehabilitation procedures. Therefore, the current study addresses the gaps by systematically comparing the effects of circuit training with and without targeted upper and lower limb resistance training using a complete set of outcome variables.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
60

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • Punjab Institute of Cardiology

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • • Adult CABG surgery candidates aged between 35 and 65 years who underwent uncomplicated CABG surgery within past 3-6 months.

    • No history of pre-existing pulmonary disease.
    • Clinically stable cardiac status and approval for participation in phase-II cardiac rehabilitation from the cardiac surgeon.
    • Patients that presented with the symptoms of mild to moderate levels of paroxysmal nocturnal dyspnea (PND). (38)
    • Willingness and availability to participate in the phase-II cardiac rehabilitation program for the study duration.
    • Physical ability to perform both upper and lower limb strength training exercise.
    • Absence of pre-existing severe orthopedic limitations that could interfere with the exercise performance.

Exclusion Criteria:

  • Uncontrolled hypertension, cardiac arrhythmias or any unstable cardiovascular complication that was an absolute contraindication to participate in clinical exercise program.
  • Severe pre-existing pulmonary conditions such as COPD or Asthma that could interfere with exercise capacity.
  • Severe orthopedic limitations such as arthritis, recent fractures and sternal site infections post-surgery.
  • Neurological complications, including stroke, severe neuropathy, balance and coordination abnormalities that could impede physical performance.
  • Cognitive impairments that may possibly affect the ability to understand and follow the exercise protocols.
  • Participation in some other structured rehabilitation program within the past month.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Group A: Circuit Training with upper and lower limb Resistance Training
A series of exercises in a circuit format with Resistance Training: for upper and lower limbs (30-40% of 1-RM)
Other: Circuit Training with upper and lower limb Resistance Training
A series of exercises in a circuit format, with 1 minute of exercise followed by 30 seconds of rest. The circuit was repeated 2-3 times, with a 2-minute break between circuits along with upper and lower limb Resistance exercises (30-40% of 1-RM) using weights and therapeutic bands
Experimental: Group B: Circuit Training only
Exercises in circuit format (30-40 minutes)
Other: Circuit Training Exercises
A series of exercises in a circuit format, with 1 minute of exercise followed by 30 seconds of rest. The circuit was repeated 2-3 times, with a 2-minute break between circuits.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Modified Medical Research Council (mMRC)
Time Frame: First day
The mMRC Dyspnea Scale is a validated tool to assess the severity of dyspnea among the patients with pulmonary complications. This scale was utilized to quantify the symptoms of paroxysmal nocturnal dyspnea among the participants in the study, offering an insight to the effectiveness of exercise interventions on the respiratory symptoms
First day
1-Repetition Maximum (1-RM)
Time Frame: First day
1-RM is a useful tool in the studies in the studies evaluating the effectiveness of strength training such as those addressing upper and lower limb resistance training. This test specifies the maximum weight that a subject can lift in a single repetition, providing a precise, quantitative baseline evaluation of dynamic strength. It can be used as a solid baseline for tracking and comparing strength changes during intervention. Thus, 1-RM is a practical and objective tool in rehabilitation research. It allows the researchers to analyze the effectiveness of certain treatments and monitor functional changes over the course of treatment or regimen.
First day
Modified Borg Scale (BORG CR-10):
Time Frame: First day
Modified Borg Dyspnea Scale is a highly validated subjective tool, to assess rate of perceived exertion during exercise to monitor exercise intensity and tailor to individual patient in cardiac rehabilitation settings. It is safe and cost-effective. It has a rating of 0-10 with zero representing (no breathlessness) and 10 (maximal exertion). It is a subjective measure of how hard the body is pushing against exertion during exercise. Specially designed for the assessment of cardiac endurance
First day
6-Minute Walk Test 6-MWT:
Time Frame: First day
It is a reliable tool for assessing functional capacity among the patient population that present with underlying cardiovascular and pulmonary conditions. We used this tool in the assessment of functional capacity among the patients that participated in the study. This test specifically measures the distance covered in 6 minutes. In this test the participant walks along a flat straight pathway (usually 30-meter indoor corridors) in six minutes at their own pace. The maximum distance covered in 6 minutes documented the functional capacity among the participants under study.
First day
Incremental Shuttle Walk Test (ISWT)
Time Frame: First day
Incremental Shuttle Walk Test (ISWT) is a highly reliable and valid tool for the assessment of cardiac endurance as a distinct outcome separately from overall functional capacity. It measures cardiac endurance under progressively increasing workloads within the safe limits. We used this tool to assess the cardiopulmonary endurance and baseline functional status in CABG population and to measure the improvements post-intervention outcomes. The test is safe, cost-effective and convenient to implement in all the clinical settings requiring little equipment and simultaneously assesses physiological responses such as heart-rate HR, oxygen saturation SPO2, and blood pressure in accordance with the subjective effort.
First day

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Riphah International University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Qurat ul Ain, MS, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
July 5, 2025

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 20, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 20, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
March 16, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 16, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 20, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 20, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 16, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • S24C14G36005 Aaima

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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