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Studies establishing V\u0307O<jats:sub>2peak<\/jats:sub>via symptom-limited exercise test with ventilatory gas analysis and reported intensity of exercise during rehabilitation were included. Studies with mean ejection fraction &lt;40% were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>128 studies including 13\u2009220 patients were included. Interventions were classified as moderate, moderate-to-vigorous or vigorous intensity based on published recommendations. Moderate and moderate-to-vigorous-intensity interventions were associated with a moderate increase in<jats:italic>relative<\/jats:italic>V\u0307O<jats:sub>2peak<\/jats:sub>(standardised mean difference\u00b195%\u2009CI=0.94\u00b10.30\u2009and 0.93\u00b10.17, respectively), and vigorous-intensity exercise with a large increase (1.10\u00b10.25). Moderate and vigorous-intensity interventions were associated with moderate improvements in<jats:italic>absolute<\/jats:italic>V\u0307O<jats:sub>2peak<\/jats:sub>(0.63\u00b10.34\u2009and 0.93\u00b10.20, respectively), whereas moderate-to-vigorous-intensity interventions elicited a large effect (1.27\u00b10.75). Large heterogeneity among studies was observed for all analyses. Subgroup analyses yielded statistically significant, but inconsistent, improvements in CRF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Engagement in exercise-based cardiac rehabilitation was associated with significant improvements in both absolute and relative V\u0307O<jats:sub>2peak<\/jats:sub>. Although exercise of vigorous intensity produced the greatest pooled effect for change in relative V\u0307O<jats:sub>2peak<\/jats:sub>, differences in pooled effects between intensities could not be considered clinically meaningful.<\/jats:p><\/jats:sec><jats:sec><jats:title>Registration<\/jats:title><jats:p>Prospero CRD42016035638.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bjsports-2018-099153","type":"journal-article","created":{"date-parts":[[2018,8,18]],"date-time":"2018-08-18T16:15:30Z","timestamp":1534608930000},"page":"1341-1351","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":52,"title":["What is the effect of aerobic exercise intensity on cardiorespiratory fitness in those undergoing cardiac rehabilitation? 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