Fridlund 1991.

Methods	Study design: Single centre RCT Country: Sweden Dates patients recruited: September 1985 to March 1988 Maximum follow up: 5 years.
Participants	Inclusion criteria: 65 years or younger at the time of MI; independent living in the Health Care District after discharge from hospital; meaningful communication and rehabilitation that was not hindered by the MI or other serious illness. Exclusion criteria: cerebral or cardiac disorders or serious alcohol abuse. N Randomised: total: 178; intervention:87 comparator: 91 Diagnosis (% of pts): MI: 100% Angina: intervention: 32.1%; comparator: 33.3% Age (years): intervention: 55; comparator: 57.6 Percentage male: 87% intervention: 86.8%; comparator: 87.3% Ethnicity: NR
Interventions	Intervention: Patients and their spouses visited the hospital for a 2 hour group session each week for 6 months. These group sessions consisted of a physical and a psychosocial part and were carried out together with a support team consisting of a physiotherapist, a physician and a rehabilitation nurse. The physical part consisted of both exercise and relaxation. Components: exercise plus psychosocial support. Setting: centre. Aerobic exercise: Modality: NR Length of session: 2 hrs. Frequency: once a week. Intensity: NR Resistance training included? NR Total duration: 6 months. Co‐interventions: The psychosocial part contained eleven themes concerning lifestyle and risks after MI and psychosocial consequences of MI. Comparator: routine cardiac follow‐up. Co‐interventions: none described.
Outcomes	Total mortality, non fatal MI, revascularisations.
Source of funding	Swedish Heart Lung Foundation, National Association for Heart and Lung Patients, Sweden, and the County Council, Halland, Sweden.
Conflicts of interest	NR
Notes	Positive long‐term effects on physical condition, life habits, cardiac health knowledge. No effects found for cardiac events or psychological condition.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	"randomly subdivided"
Allocation concealment (selection bias)	Unclear risk	Not reported.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Blinding not described.
Incomplete outcome data (attrition bias) All outcomes	High risk	32% lost to follow up, no description of withdrawals or dropouts.
Selective reporting (reporting bias)	Low risk	All outcomes reported at all time points (although absolute values not always given).
Groups balanced at baseline	Low risk	“All differences are non‐significant according to the chi‐square test and /or ANOVA test”.
Intention‐to‐treat analysis conducted	Low risk	Yes.
Groups received same treatment (apart from the intervention)	High risk	"The rehabilitation programme involved two intervention strategies as its main objective (a) lifestyle and life stress orientated and (b) social support oriented…..group sessions consisted of a physical and a psychosocial part and were carried out together with a support team…”