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Therapeutics
Review: exercise training in patients with heart failure is safe

https://doi.org/10.1136/ebm.9.6.174

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    Smart N, Marwick TH. Exercise training for patients with heart failure: a systematic review of factors that improve mortality and morbidity. Am J Med 2004;116:693–706.
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 Q Is exercise training safe in patients with heart failure?

    Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ IM/Ambulatory care ★★★★★☆☆ Cardiology ★★★★☆☆☆

    METHODS

    Embedded ImageData sources:

    Medline (1966 to August 2003), Medscape (1979 to August 2003), the Cochrane Controlled Trials Registry (1979 to August 2003), hand searching relevant journals, and bibliographies of identified articles.

    Embedded ImageStudy selection and assessment:

    clinical trials comparing exercise training with no exercise training in patients with ejection fraction <40% and data were presented on mortality or adverse events. Studies examining the effects of a single exercise session were excluded.

    Embedded ImageOutcomes:

    mortality rates and adverse events (incidents causing withdrawal from the exercise program, including hospital admission).

    MAIN RESULTS

    81 studies met the inclusion criteria (30 parallel group randomised controlled trials [RCTs]; 9 randomised crossover trials; 5 non-randomised controlled trials; and 37 cohort studies). The 30 parallêl-group RCTs included 1197 patients. Among these RCTs, training duration ranged from 15 minutes 3 …

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