{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:06:13Z","timestamp":1790834773784,"version":"4.1.0"},"reference-count":37,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: To evaluate the associations and concurrent validity between baseline functional and morphofunctional assessments in patients with cardiovascular disease participating in a Phase II cardiac rehabilitation program, as a basis for informing individualized exercise prescription. Methods: We conducted an observational retrospective cross-sectional study of patients enrolled in a Phase II outpatient cardiac rehabilitation program (January 2021\u2013December 2023, M\u00e1laga). Functional assessments included handgrip strength (HGS), isometric biceps and quadriceps dynamometry, and direct assessment of 20-repetition maximum (20RM) through dynamic resistance exercises using external loads (defined as the maximum load allowing approximately 20 repetitions to near muscular fatigue). Aerobic capacity was evaluated using the 6-min walk test (6 MWT) and a modified Bruce exercise stress test with estimated METs. Morphofunctional assessment included vector bioimpedance analysis (phase angle [PhA], fat-free mass [FFM], body cell mass [BCM]) and rectus femoris ultrasound (cross-sectional area [RF-CSA] and contracted diameter [RF-CON]). Correlation and linear regression analyses were performed. Results: The sample included 223 participants (78.0% male; age 57.7 \u00b1 8.6 years). HGSmax correlated strongly with 20RM biceps (r = 0.89) and moderately with quadriceps (r = 0.72). 6 MWT distance and speed correlated with ergometry-derived METs (r = 0.38\u20130.40; p &lt; 0.001), whereas Borg ratings correlated inversely with METs and exercise time (r = \u22120.32 to \u22120.34; p &lt; 0.001). PhA, BCM, FFM, and rectus femoris ultrasound measures correlated with both strength and aerobic outcomes (\u03c1 \u2248 0.33\u20130.50; all p &lt; 0.001). In regression analyses, HGSmax was the main predictor of 20RM biceps (R2 = 0.792) and showed moderate predictive capacity for quadriceps performance (R2 = 0.521). The MET model demonstrated limited explanatory capacity (R2 = 0.288). Conclusions: The integration of simple, accessible, and reproducible tools such as HGS and the 6 MWT with morphofunctional parameters may provide a pragmatic approach to support individualized exercise prescription in cardiac rehabilitation. While stronger associations were observed for upper-limb resistance performance, the predictive capacity for lower-limb strength and aerobic exercise intensity was more moderate and should be interpreted cautiously. These findings support the potential clinical utility of combining functional and morphofunctional assessments in routine cardiac rehabilitation practice.<\/jats:p>","DOI":"10.3390\/jcm15114336","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T13:46:48Z","timestamp":1780494408000},"page":"4336","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Functional Thresholds Derived from Dynamometry and 6-Minute Walk Test with Morphofunctional Assessment to Guide Individualized Exercise Prescription in Cardiac Rehabilitation"],"prefix":"10.3390","volume":"15","author":[{"given":"Mar\u00eda del Mar","family":"Amaya-Campos","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica y Plataforma en Nanomedicina, M\u00e1laga Biomedical Research Institute and BIONAND Platform, 29010 Malaga, Spain"},{"name":"Department of Medicine and Dermatology, M\u00e1laga University, 29016 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram\u00f3n Zafra","family":"Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Unit, Son Espases University Hospital, 07120 Palma de Mallorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roc\u00edo","family":"Fern\u00e1ndez-Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica y Plataforma en Nanomedicina, M\u00e1laga Biomedical Research Institute and BIONAND Platform, 29010 Malaga, Spain"},{"name":"Department of Medicine and Dermatology, M\u00e1laga University, 29016 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel M.","family":"Vegas-Aguilar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica y Plataforma en Nanomedicina, M\u00e1laga Biomedical Research Institute and BIONAND Platform, 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Garc\u00eda-Olivares","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica y Plataforma en Nanomedicina, M\u00e1laga Biomedical Research Institute and BIONAND Platform, 29010 Malaga, Spain"},{"name":"Department of Medicine and Dermatology, M\u00e1laga University, 29016 Malaga, Spain"},{"name":"Department of Endocrinology and Nutrition, Quiron Salud M\u00e1laga Hospital, Av. Imperio Argentina, 29004 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica Diaz-Cordov\u00e9s","family":"Rego","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine Unit, Virgen de la Victoria University Hospital, 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yolanda Ruiz","family":"Molina","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine Unit, Virgen de la Victoria University Hospital, 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adela Mar\u00eda","family":"G\u00f3mez Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica y Plataforma en Nanomedicina, M\u00e1laga Biomedical Research Institute and BIONAND Platform, 29010 Malaga, Spain"},{"name":"Rehabilitation Medicine Unit, Virgen de la Victoria University Hospital, 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel Montiel","family":"Trujillo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Virgen de la Victoria University Hospital, 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Tinahones-Madue\u00f1o","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica y Plataforma en Nanomedicina, M\u00e1laga Biomedical Research Institute and BIONAND Platform, 29010 Malaga, Spain"},{"name":"Department of Medicine and Dermatology, M\u00e1laga University, 29016 Malaga, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Carlos III Health Institute (ISCIII), University of M\u00e1laga, 29016 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Manuel","family":"Garc\u00eda-Almeida","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica y Plataforma en Nanomedicina, M\u00e1laga Biomedical Research Institute and BIONAND Platform, 29010 Malaga, Spain"},{"name":"Department of Medicine and Dermatology, M\u00e1laga University, 29016 Malaga, Spain"},{"name":"Department of Endocrinology and Nutrition, Quiron Salud M\u00e1laga Hospital, Av. Imperio Argentina, 29004 Malaga, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Carlos III Health Institute (ISCIII), University of M\u00e1laga, 29016 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc\u00eda Jim\u00e9nez","family":"Laguna","sequence":"additional","affiliation":[{"name":"Department of Medicine and Dermatology, M\u00e1laga University, 29016 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2025, September 20). 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