Is exercise-based cardiac rehabilitation effective? A systematic review and meta-analysis to re-examine the evidence
BMJ Publishing Group
MetadataShow full item record
Objectives: To determine the contemporary effectiveness of exercise-based cardiac rehabilitation (CR) in terms of all-cause mortality, cardiovascular mortality and hospital admissions. Data sources: Studies included in or meeting the entry criteria for the 2016 Cochrane review of exercise-based CR in patients with coronary artery disease. Study eligibility criteria: Randomised controlled trials (RCTs) of exercise-based CR versus a no-exercise control whose participants were recruited after the year 2000. Study appraisal and synthesis methods: Two separate reviewers independently screened the characteristics of studies. One reviewer quality appraised any new studies and assessed their risk of bias using the Cochrane Collaboration’s recommended risk of bias tool. Data were reported as the risk difference (95% CI). Results: We included 22 studies with 4834 participants (mean age 59.5 years, 78.4% male). We found no differences in outcomes between exercise-based CR and a no-exercise control at their longest follow-up period for: all-cause mortality (19 studies; n=4194; risk difference 0.00, 95% CI −0.02 to 0.01, P=0.38) or cardiovascular mortality (9 studies; n=1182; risk difference −0.01, 95% CI −0.02 to 0.01, P=0.25). We found a small reduction in hospital admissions of borderline statistical significance (11 studies; n=1768; risk difference −0.05, 95% CI −0.10 to −0.00, P=0.05). Conclusions and implications of key findings: Our analysis indicates conclusively that the current approach to exercise-based CR has no effect on all-cause mortality or cardiovascular mortality, when compared with a no-exercise control. There may be a small reduction in hospital admissions following exercise-based CR that is unlikely to be clinically important.
Powell, R., McGregor, G., Ennis, S., Kimani, P.K. and Underwood, M. (2018) 'Is exercise-based cardiac rehabilitation effective? A systematic review and meta-analysis to re-examine the evidence', BMJ Open, 8(3), p.e019656. DOI: 10.1136/bmjopen-2017-019656.
Article published in BMJ Open on 14 March 2018, available open access at: http://dx.doi.org/10.1136/bmjopen-2017-019656.
Cardiff Metropolitan University (Grant ID: Cardiff Metropolian (Internal))
- Sport Research Groups 
Showing items related by title, author, subject and abstract.
Davenport, M.H.; Kathol, Amariah; Mottola, Michelle; Skow, Rachel; Meah, Victoria L.; Poitras, Veronica; Jaramillo Garcia, Alejandra; Gray, Casey; Barrowman, Nick; Riske, Laurel; Sobierajski, F.; James, Marina; Nagpal, Taniya; Marchand, Andree-Anne; Slater, Linda; Adamo, Kristi; Davies, Gregory; Barakat, Ruben; Ruchat, Stephanie-May (BMJ Publishing Group, 2018-10-18)Objective. To perform a systematic review of the relationship between prenatal exercise and fetal or newborn death. Design. Systematic review with random-effects meta-analysis and meta-regression. Data sources. Online ...
Turner, James (Cardiff Metropolitan University, 2013)Background: A lack of regular physical activity has become the fourth leading risk factor for global mortality today. Several physiological and psychological factors can decrease physical activity levels, such as age, ...
Wolmarans, Jennifer (2018-05-01)The current study measured the predictive value of trait mindfulness and openness to experience on different facets of mortality awareness in a middle-aged sample. Most research on mortality awareness have focused on ...