Gielen 2003

Methods	Parallel group RCT
Participants	N Randomised: 20 (exercise 10; control 10) Diagnosis (% of participants): Aetiology: IHD; DCM NYHA: Class II 90%; Class III 10% LVEF: exercise mean 26.1% (SD 6); control mean 24.7% (SD 8) Case mix: 100% as above Age (yr): exercise 55 (SD 6); control 53 (SD 9) Male: 100% White: not reported Inclusion/exclusion criteria Inclusion: age < 70 yr with CHF (NYHA II to III) as result of DCM or IHD as assessed by cardiac catheterisation. All had clinical, radiological and echocardiographic signs of CHF and an LVEF 40% as assessed by ventriculography and clinically stable condition for > 3 months before enrolment Exclusion: significant valvular heart disease, uncontrolled hypertension, peripheral vascular disease, pulmonary disease or musculoskeletal abnormalities precluding exercise training
Interventions	Exercise:Total duration: 2 wk inpatient followed by 6 months as outpatient Aerobic/resistance/mix: aerobic Frequency: 7 sessions/wk Duration: 20 min/session Intensity: 70% symptom limited VO2 max Modality: cycle ergometers Setting: supervised sessions at hospital and home‐based unsupervised sessions Other: expected to participate in 1 group training session (walking, callisthenics and non‐competitive ball games) of 60 min each wk. Participants were asked to exercise for 20 min/day at home
Outcomes	Mortality
Comparison	Continued their sedentary lifestyle and remained on their individually tailored cardiac medication supervised by their private physicians
Country and setting	Switzerland Single centre
Follow‐up	26 wk (after randomisation)
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Not reported
Allocation concealment (selection bias)	Unclear risk	Not reported
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Not reported
Selective reporting (reporting bias)	Low risk	All outcomes described in methods are reported in results
Intention‐to‐treat analysis?	Low risk	Although ITT analysis not reported, groups do appear to be analysed according to original randomised allocation
Incomplete outcome data?	Low risk	No loss to follow‐up
Groups balanced at baseline?	Low risk	"Patients in the training group and in the control group showed a significantly reduced left ventricular ejection fraction (training group: 26.1 ±3.1%, control group: 24.7± 2.4%; NS [not significant]) and exercise capacity as determined by peak oxygen uptake (training group: 20.3 ±1.0 ml/kg min, control group: 17.9 ±1.6 ml/kg min; P NS)"
Groups received same intervention?	Unclear risk	Details of co‐interventions not reported