Rivas 1988.

Methods	Study design: 3‐arm RCT Recruitment: first AMI patients admitted to CCU Allocation: not reported Blinding: not reported Randomisation: no method described Follow‐up(s): 3 months, 6 months, 9 months, 12 months Description: combined outpatient rehabilitation including supervised training with psychological and vocational counselling with more (group A) and less (group B) intense physical training
Participants	Baseline characteristics Intervention group (rehabilitation group A) Mean age (SD): 46.7 (9) Sex (male %): 85.5 Number of participants randomised: 55 Working before CHD: 50 Interventions group (rehabilitation group B) Mean age (SD): 46.7 (8) Sex (male %): 90.7 Number of participants randomised: 52 Working before CHD: 52 Control group Mean age (SD): 50.3 (9) Sex (male %): 88.7 Number of participants randomised: 48 Working before CHD: 48 Inclusion criteria MI confirmed according to the WHO criteria No present further complications (moderate or severe cardiac insufficiency, dangerous ventricular arrhythmias uncontrolled with drugs, and physical or physical disability that do not allow for correct rehabilitation) Exclusion criteria: none Baseline imbalances: ‐ Physically demanding work: white‐collar Severity of CHD: unclear
Interventions	Intervention characteristics Rehabilitation group A (more intense physical training) Ambulatory integral cardiac rehabilitation with supervised daily physical training (monday‐friday) Measures to control the coronary risk factors Physical training, psychological support, occupational orientation, vocational and social orientation Clinical follow‐up through frequent medical consultations with a cardiologist, who was in charge of indicating whether a medical or surgical treatment was required according to patient’s needs Physical training sessions for 15 minutes: callisthenic exercises, pedaling a stationary bike and jogging for 30 min with the required intensity to reach individual training pulse (previously determined through ergometric testing) Monthly health education talks; topics: prevention and the treatment of Ischaemic heart disease, sexual activity, resumption of work and social activities, etc., with the goal of increasing patient’s knowledge about the disease Starting from the 3rd week after the MI and until the 10th week Then 3 times per week until at least the first year Duration of intervention: at least 1 year Providers: ‐ Rehabilitation group B (less intense physical training) Ambulatory integral cardiac rehabilitation with supervised physical training 3 times per week from the 8th week after the MI episode and for ≥ 1 year Between hospital discharge and the 8th week unsupervised programme of physical exercises at home (callisthenics, steps, walks) Duration of intervention: at least 1 year Providers: ‐ Control group After discharge the participants were seen by a cardiologist in a conventional external medical consultation without being assigned to a specific rehabilitation programme
Outcomes	Proportion at work at < 6 months (short term): 3 months Proportion at work at 6–12 months (medium term): 12 months Adverse events (mortality)
Identification	Sponsorship source: Institute of Cardiology and Cardiovascular Surgery, Rehabilitation Center Country: Cuba Setting: single centre (Institute of Cardiology and Cardiovascular Surgery, Rehabilitation Center), ambulant Possible conflicts of interest: no information provided Ethics committee approval: not reported
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "...patients were randomly distributed according to a table of random numbers in three groups"
Allocation concealment (selection bias)	Unclear risk	No method of allocation concealment is described.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Due to the nature of the intervention (outpatient exercise programmes), blinding of participants and personnel would not have been possible.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	No blinding of outcome assessors, nor is the method of assessing RTW is mentioned
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	For intervention group A and the control group, the number of study participants reported to be lost to follow‐up due to death was the same (n = 1). Together in groups A and B a total of 3 study participants were lost due to retirement compared to 5 study participants in the control group.
Selective reporting (reporting bias)	Unclear risk	Unable to determine, no study protocol was available
Other bias	Unclear risk	None identified