Summary of findings 3. Physical conditioning interventions compared to usual care for people with coronary heart disease.
| Physical conditioning interventions compared to usual care for people with coronary heart disease | ||||||
| Patient or population: people with coronary heart disease Setting: hospital/home Intervention: physical conditioning interventions Comparison: usual care | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with usual care | Risk with physical conditioning interventions | |||||
| Proportion of participants returning to work in the short term (up to 6 months) Follow‐up: range 3 months to 5.5 months | Study population | RR 1.17 (0.97 to 1.41) | 460 (4 RCTs) | ⊕⊝⊝⊝ Very low1,2,3 | We do not know if physical conditioning interventions increase the proportion returning to work in the short term (up to 6 months) | |
| 68 per 100 | 80 per 100 (66 to 96) | |||||
| Proportion of participants returning to work in the medium term (6 months‐1 year) Follow‐up: range 0.5 years to 1 years | Study population | RR 1.09 (0.99 to 1.20) | 510 (5 RCTs) | ⊕⊕⊝⊝ Low1 4 | Physical conditioning interventions may result in little to no difference in proportion returning to work in the medium term (6 months‐1 year) | |
| 75 per 100 | 82 per 100 (74 to 90) | |||||
| Proportion of participants at work in the long term (> 1 to < 5 years) Follow‐up: range 3 years to 4 years | Study population | RR 1.04 (0.82 to 1.30) | 156 (2 RCTs) | ⊕⊕⊝⊝ Low1 | Physical conditioning interventions may result in little to no difference in proportion at work in the long term (> 1 to < 5 years) | |
| 64 per 100 | 67 per 100 (53 to 84) | |||||
| Proportion of participants at work in the extended long term (≥ 5 years) Follow‐up: mean 5 years | Study population | RR 1.83 (1.26 to 2.66) | 119 (1 RCT) | ⊕⊕⊝⊝ Low5 | Physical conditioning interventions may increase the proportion at work in the extended long term (≥ 5 years) | |
| 37 per 100 | 68 per 100 (47 to 99) | |||||
| Days until return to work | The mean time to return to work was 7.86 days lower (29.46 lower to 13.74 higher) | ‐ | 430 (4 RCTs) | ⊕⊕⊝⊝ Low1 2 | Physical conditioning interventions appear to result in little to no difference in mean time to return to work (days) | |
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Adverse effects: cardiac deaths Follow‐up: mean 4.8 years |
8 per 100 | 8 per 100 (3 to 24) | RR 1.00 (0.35 to 2.80) | 285 (2 RCTs) | ⊕⊕⊕⊝ Moderate3 | Physical conditioning interventions probably do not increase adverse effects (cardiac deaths) |
| *The risk in the Intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trials; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
1Downgraded one level due to risk of bias. 2Downgraded one level due to substantial heterogeneity that we could not completely explain. 3Downgraded one level due to imprecision (pooled confidence interval is wide and includes either a possible appreciable harm or benefit). 4Downgraded one level, because results of funnel plot indicated possible publication bias. 5Downgraded one level because only one study reported the proportion of study participants working five years after the intervention.