Skip to main content
. 2016 Jan 5;2016(1):CD001800. doi: 10.1002/14651858.CD001800.pub3

Munk 2009.

Methods Study design: Single centre RCT
Country: Norway
Dates patients recruited: NR
Maximum follow up: 6 months
Participants Inclusion criteria: Successful PCI, defined as a residual diameter stenosis after stent implantation of < 20% of the reference diameter.
Exclusion criteria: History of myocardial infarction (MI) or CABG; significant valvular heart disease; > 80 years; inability to give informed consent; inability to participate in regular training due to residency, work situation or comorbidity; any known chronic inflammatory disease other than atherosclerosis, or planned surgery within the next 6 months.
N Randomised: total: 40; intervention: 20; comparator: 20
Diagnosis (% of pts):
Stable angina, post PCI: intervention: 85%; comparator: 95%
Unstable angina, post PCI: intervention: 15%; comparator: 5%
Age (mean ± SD): intervention: 57 ±14; comparator: 61 ± 10
Percentage male: Total: 21%; intervention: 18%; comparator: 25%
 Ethnicity: NR
Interventions Intervention: Starting 11 ± 4 days after PCI,the training model included 10 min warm‐up at 60% to 70% of max HR, followed by 4 min intervals at 80% to 90% of max HR, when patients were riding an ergometric bicycle or were running. Intervals were interrupted by 3 minutes of active recovery at 60% to 70% of maximal heart rate. Afterwards, there was 5 min cool‐down, 10 min of abdominal and spine resistance exercises, and 5 min of stretching and relaxing. The training sessions were monitored with individual pulse watches allowing the patient to achieve the target heart rate.
Components: exercise only.
Setting: centre‐based supervised training in groups of 10.
Aerobic exercise:
Modality: ergometric bicycle or running.
Length of session: 1 hour.
Frequency: 3 times a week.
Intensity: 60‐70% max HR.
Resistance training included? Spine & abdominal resistance exercises.
Total duration: 6 months.
Co‐interventions: None described.
Comparator: Participants received usual care (not described), including drug therapy of clopidogrel, aspirin and statins.
Co‐interventions: None described.
Outcomes Mortality, MI, and revascularisations.
Source of funding Norwegian Health Association, Oslo, Norway, and Stavanger University Hospital.
Conflicts of interest NR in this paper, but none declared in Munk 2011.
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk “The order of treatments within the block was randomly permuted by a computer‐generated sequence.”
Allocation concealment (selection bias) Low risk “The investigator, who recruited patients into the trial, was unaware of the group to which a participant was allocated.”
Blinding of outcome assessment (detection bias) 
 All outcomes Low risk “All scans were analysed twice with EchoPACtm (GE Vingmed Ultrasound) by two blinded investigators. Two experienced cardiologists independently interpreted the images in a blinded manner.” However, not clear if blinded for clinical events and exercise capacity.
Incomplete outcome data (attrition bias) 
 All outcomes Low risk “No patient was lost to follow up.”
Selective reporting (reporting bias) Low risk All outcomes described in methods were reported at all time points.
Groups balanced at baseline Low risk “There were no significant differences in risk profile, clinical presentation, medical treatment, or angiographic or procedural characteristics between the 2 groups.”
Intention‐to‐treat analysis conducted Unclear risk Not stated but no loss to follow up and groups appear to be analysed according to original random allocation.
Groups received same treatment (apart from the intervention) Low risk “All patients received Aspirin, Clopidogrel and a statin during the study period.”