ObjectivesTo evaluate the effects of a cardiac rehabilitation programme based on neuromuscular training (NMT) compared with classic rehabilitation strength training (CRST) in patients diagnosed with acute coronary syndrome (ACS). DesignPreliminary randomised, double-blinded, parallel clinical trial. SettingUniversity health clinic in Valencia, Spain. ParticipantsThirty patients with ACS, InterventionsPatients were assigned to one of two groups at random: the NMT group (n=15) and the CRST group (n=15). All patients attended the 20 sessions of the exercise programme. Main outcome measuresThe primary outcome was the Incremental Shuttle Walk Test (ISWT). The secondary outcomes were the Chester Step Test (CST), the 30-Second Chair Stand Test (30CST), and hip flexor dynamometry. Assessments were made at baseline, immediately post-treatment, and at 6-month follow-up. ResultsThe NMT group showed a greater improvement in the ISWT than the CRST group, both at post-treatment {mean 648 [standard deviation (SD) 197] vs 493 (SD 219), mean difference 155, 95% confidence interval (CI) -1 to 310} and at follow-up [732 (SD 183) vs 518 (SD 222), mean difference 214, 95% CI 61 to 367]. The secondary outcomes showed significant between-group differences in favour of the NMT group at 6-month follow-up, except for the 30CST. ConclusionsThese preliminary findings indicate that a cardiac rehabilitation programme based on NMT may improve functional capacity in terms of patient performance, cardiorespiratory fitness and muscle strength. Moreover, the improvements were maintained at medium-term follow-up. This could help improve the design of rehabilitation sessions, considering factors associated with performing everyday activities in patients affected by ACS.