Sire 1987.

Study characteristics
Methods	Study design: prospective randomised study No of centres: 1 trial centre but 2 patients received training at local hospital Country: Norway Dates patients recruited: NR When randomised: 2 months after operation Maximum follow‐up (from baseline): 12 months
Participants	Inclusion criteria: had isolated aortic valve replacement and could tolerate and perform a physical training programme Exclusion criteria: signs and symptoms of other heart disease, over 60 years of age, disease in the locomotor system, obvious mental ailments or social disturbances (e.g. alcoholics). Male patients with heart volumes exceeding 750 mL m‐2 BSA and females with hearts larger than 650 mL m‐2 BSA were also excluded N Randomised: total: 44;intervention: 21;comparator: 23   Diagnosis (% of pts) e.g. Aetiology: (total): 27.3% due to aortic stenosis (n = 12), 31.8% due to aortic insufficiency (n = 14), 40.9% due to combined aortic stenosis and insufficiency (n = 18) NYHA: NR LVEF: NR Case mix Age (mean ± SD): total: NR; intervention: 45.5 ± 11.7;comparator: 45.5 ± 12.2 Percentage male: total: male 36, female 8; intervention: male 18, female 3; comparator: male 18, female 3   Ethnicity: NR
Interventions	Intervention (exercise‐based CR) Description: exercise was divided into 2 phases: centre‐based training (consisting of several types of exercise + 30‐minute cooling down period at the end), and home‐based training (consisting of a few simple daily exercises) Time of start after event: 2 months after surgery Components: exercise Detail of exercise: started with 15‐minute bicycle warm‐up session, then short programme of 30 minutes (with 20 different arm and leg exercises of 1 to 2 minutes each). Calisthenics of alternative heavy (e.g. jogging, jumping) or light (e.g. rocking sit‐ups, arm flinging at slow speeds) exercises were then carried out for 1 hour, followed by playing volleyball for 30 minutes and a 1‐hour break. Selected exercises from the above were then repeated, before the session concluded with a 30‐minute cooling down period Modality: bicycle ergometer + aerobics + calisthenics Dose of exercise: (calculated as overall no. of weeks of training multiplied by mean number of sessions per week multiplied by mean duration of sessions in minutes): NR (centre) + NR (home) Length of session: 3 to 4 hours Frequency/no. of sessions: daily Intensity: individualised to patient (upper pulse limit during training was adjusted to 85% to 90% of maximal heart rate obtained at initial exercise test) Resistance training included: yes, isometric arm and leg exercises Total duration: 4 weeks Setting: home/hospital/Internet delivery or combination: hospital + home Supervision: supervised/unsupervised/not reported: centre‐based supervised, home‐based not supervised Intermittent nurse or exercise specialist support? NR Co‐interventions: NR Comparator Description: patients were not encouraged to start any systematic training (no patients started this). Patients reported moderate daily physical activity at each control visit Co‐interventions: NR
Outcomes	Outcomes (scale measured in): return to work, exercise capacity (cumulated work, i.e. work performed + workload) Other outcomes measured Physical work capacity
Notes	Follow‐up at 2, 6, and 12 months In training group, 3 patients did not perform the exercise test at the end of the training period (i.e. at 3 months after surgery) for non‐medical reasons, and 1 patient did not attend the 12‐month control In the control group, 2 patients were unable to participate 7.5 and 8 months following surgery due to a non‐fatal thromboembolic episode, and 1 patient did not come to the 12‐month review for non‐medical reasons Only 15 male participants from the training group and 16 male participants from the control group were included in the exercise capacity assessments, as females could not reach the highest comparable workload (100W)