Gottlieb 1999

Methods	Parallel group RCT
Participants	N Randomised: 33 Diagnosis (% of participants): Aetiology: ischaemic or primary NYHA: Class II or III LVEF: exercise 22% (SD 8); control 25% (SD 10) Case mix: 100% as above Age (yr): exercise 67 (SD 7); control 64 (SD 10) Male: exercise 15/16 (94%); control 11/14 (79%); total 87% White: not reported Inclusion/exclusion criteria Inclusion: NYHA Class II‐III for at least 3 months and were on stable medications for the past 1 month. All participants were on maximal medical therapy with angiotensin‐converting enzyme inhibitors, diuretic and digoxin. All participants had EF < 40% by nuclear ventriculography. No participants had obstructive valvular disease, MI within 3 months, or limitation of exercise secondary to angina or new arrhythmias Exclusion: not reported
Interventions	Exercise:Total duration: 3 months Aerobic/resistance/mix: aerobic Frequency: 3 session/wk Duration: 30 min Intensity: Borg 12‐13 Modality: bike and treadmill Setting: supervised sessions at medical centre by a nurse or exercise physiologist Other: Care provided by specialist HF physician
Outcomes	HRQoL (MLWHFQ and MOS SF‐36 questionnaire), mortality, morbidity
Comparison	Usual medical care Other: care provided by specialist HF physicians
Country and setting	USA Single centre
Follow‐up	6 months (after randomisation)
Notes	MLWHF, MOS SF‐36 results not reported for the control group
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
Intention‐to‐treat analysis?	Unclear risk	Not reported
Incomplete outcome data?	Low risk	Yes, QUORUM flow diagram reported Unclear how loss to follow‐up, drop‐out and cross‐over dealt with
Groups balanced at baseline?	Low risk	"There were no differences at baseline between patients randomised to the control group and those randomised to the exercise program"
Groups received same intervention?	Low risk	"Medical follow‐up of both the control and intervention patients groups was provided by specialized heart failure physicians"