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. 2021 Nov 6;2021(11):CD001800. doi: 10.1002/14651858.CD001800.pub4

Miller 1984.

Study characteristics
Methods Study design: RCT; participants randomised 3 weeks post‐MI
Country: USA
Dates participants recruited: NR
Maximum follow‐up: 6 months
Participants Inclusion criteria: men < 70 years with MI documented by the combination of characteristic elevation of serum creatine kinase or oxaloacetic transaminase, a history of prolonged chest pain consistent with myocardial infarction, and the appearance of new Q waves or evolutionary ST segment changes.
Exclusion criteria: conditions that precluded symptom‐limited treadmill testing 3 weeks after infarction. e.g. congestive heart failure, unstable angina pectoris, valvular heart disease, atrial fibrillation, bundle branch block, stroke, limiting orthopedic abnormalities, peripheral vascular disease, chronic obstructive pulmonary disease and obesity, a history of coronary artery bypass graft (CABG) surgery, reinfarction before testing, and intercurrent noncardiac illness.
N randomised: total: 198; group 1: 66; group 2: 61; group 3: 34; comparator: 37
Diagnosis (% of participants): MI: 100%
Age (mean ±SD): 52 ± 9
Percentage male: 100%
Ethnicity: NR
Interventions Participants were randomly assigned to one of four exercise protocols:
  • group 1: 8 to 26 weeks of training at home;

  • group 2: training in a group programme;

  • group 3: treadmill testing at 3 weeks without subsequent training;

  • control: treadmill testing for the first time at 26 weeks.


Regimens of home and group exercise training were designed to provide a similar intensity and duration of exercise training.
Intervention: home training
Components: exercise only
Setting: home
Exercise programme modality: stationary cycling or walking
Length of session: 30 min
Frequency: 5 days a week
Intensity: weeks 3 to 11: 70% to 85% of the peak heart rate at week 3; weeks 11 to 26: 70% to 85% of the peak heart rate at week 11.
Resistance training included? No
Total duration: 8 weeks or 26 weeks.
Co‐interventions: none described
Intervention: group training
Components: exercise
Setting: supervised in centre
Exercise programme modality: walking or jogging
Length of session: 1 hour
Frequency: 3 times a week
Intensity: participants regulated their training intensity by palpation of the radial or carotid pulse during the first 10 sec after brief cessation of walking or jogging.
Resistance training included? No
Total duration: 8 weeks or 26 weeks
Co‐interventions: none described
Comparator: usual care (treadmill testing for the first time at 26 weeks)
Co‐interventions: none described
Outcomes CHD mortality, non‐fatal MI and revascularisation
Source of funding Supported by grant from the NHLBI, Bethesda, and by a grant from the PepsiCo Foundation, Purchase, NY
Conflicts of interest NR
Notes Low rate of cardiac events reflects identification of low risk population
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 of outcome assessment (detection bias)
All outcomes Unclear risk Blinding not described
Incomplete outcome data (attrition bias)
All outcomes High risk 5% lost to follow‐up; no description of withdrawals or dropouts
Selective reporting (reporting bias) Low risk All outcomes reported for all time points