Stern 1983.

Study characteristics
Methods	Study design: single‐centre RCT Country: USA Dates participants recruited: NR Maximum follow‐up: 1 year. Randomised by blocks of 6 into one of three groups: exercise, group counselling & control.
Participants	Inclusion criteria: Aged 30 to 69 years with documented MI not less than six weeks nor more than one year prior to admission to the study. Work capacity level < 7 MET (men) or < 6 MET (women) or a Taylor Manifest Anxiety Scale raw score of 19 + or Zung Self‐rating Depression Scale raw score of 40 +, or any or all of these. Exclusion criteria: Presence of unstable cardiovascular condition i.e. congestive heart failure, or requirement of treatment for any physical/psychological reason. N randomised: total: 106; intervention: 42; comparator (usual care): 29; group counselling: 35 (no data analysed in this review) Diagnosis (% of participants): MI: 100% Age (mean): 54 Percentage male: intervention: 90%; comparator: 76% Ethnicity: 85% white
Interventions	Intervention: Three one‐hour sessions per week over a 12‐week period. All exercises were dynamic, involving rhythmic movements against resistance. Half were upper limb (rowing machine, arm wheel, and arm ergometer) and half were lower limb (treadmill, cycle, and step ergometer). Participants exercised upper and lower limbs alternately for four minutes with two minutes of rest in between. The intensity of exercise was determined by heart‐rate response, the target level being 85% of the peak exercise heart rate achieved in the first evaluation. If the heart rate was consistently above or below target, the work load was increased or decreased. Components: exercise. Setting: supervised in a centre. Exercise programme modality: e.g. rowing, treadmill, cycle or step ergometer. Length of session: 1 hour. Frequency: 3 times a week. Intensity: Target HR 85% of HR max at exercise tolerance test. Resistance training included? No. Total duration: 12 weeks. Co‐interventions: none described. Comparator: followed up by their physicians and given routine post‐MI medical care. Participants were requested to not join a supervised exercise or a formal counselling programme. Co‐interventions: none described.
Outcomes	Mortality, non‐fatal MI.
Source of funding	National Institute of Handicapped Research, Department of Education, Washington, DC.
Conflicts of interest	Not reported
Notes	Minimal differences between groups at one year.
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	7.7% lost to follow‐up; no description of withdrawals or dropouts.
Selective reporting (reporting bias)	Low risk	All outcomes reported for all time points.