Holmbäck 1994.

Methods	Study design: Single centre RCT Country: Sweden Dates patients recruited: "during a 2‐year period" Maximum follow up: 1 yr
Participants	Inclusion criteria: Acute MI patients under 65 years of age. Exclusion criteria: Not stated but patients have been excluded for being incapable of performing strenuous training due to poor left ventricular function or arrhythmias, orthopaedic disorders, other incapacitating somatic diseases or mental disorders. N Randomised: total: 69; intervention: 34; comparator:35 Diagnosis (% of pts): Post‐MI: 100% Age (mean years [range]): intervention: 55 (38‐65); comparator:55 (43‐63) Percentage male: 97% Ethnicity: NR
Interventions	Intervention: Started 8 weeks post‐MI and patients trained over a 12‐week period for at least 45 minutes (effective time) twice a week with interval training involving large muscle groups: bicycling (10 min), calisthenics (10 min), jogging (15 min) ending with relaxation (10 min). Components: exercise only. Setting: not described, but assumed in a centre. Aerobic exercise: Modality: bicycling 10 mins, 10min, jogging. Length of session: at least 45 mins. Frequency: twice per week. Intensity: 70% to 85% of peak heart at the bicycle test for initial session and workload individually adjusted to obtain the desired maximum heart rate if possible. Resistance training included? callisthenics. Total duration: 12 weeks. Co‐interventions: none described. Comparator: recieved regular medical care with no emphasis on exercise. Co‐interventions: none described.
Outcomes	Total mortality, non‐fatal MI & revascularisation. Health‐related quality of life: self‐report questionnaire. Evaluations at 6 weeks and 1 year post MI.
Source of funding	Research support was given by Malmöhus County Council.
Conflicts of interest	NR
Notes	Study authors found no benefit from exercise training. Outcomes were related to self‐rated levels of physical and psychological well being.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	"Randomization was performed according to random numbers in sealed envelopes".
Allocation concealment (selection bias)	Low risk	"Randomization was performed according to random numbers in sealed envelopes".
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Evaluations were "supervised by independent investigators".
Incomplete outcome data (attrition bias) All outcomes	High risk	14.5% lost to follow up, no description of withdrawals or dropouts.
Selective reporting (reporting bias)	Low risk	All outcomes reported for all time points (although absolute values not always given).
Groups balanced at baseline	Low risk	Balanced except some some differences in MI situation.
Intention‐to‐treat analysis conducted	High risk	No.
Groups received same treatment (apart from the intervention)	Low risk	“Patients were randomised to either an exercise or a non‐exercise group….. No special psychosocial benefits were given to the training group. The control group received regular medical care with no special emphasis on exercise.”