Is exercise-based cardiac rehabilitation effective and safe for adults with heart failure?

Chronic heart failure is a common health problem in which people experience fatigue and shortness of breath that limit their activities and restrict their participation, thus negatively impacting their perception of quality of life. 
International clinical guidelines support the role of exercise-based cardiac rehabilitation in the management of these patients. However, the provision of rehabilitation remains internationally deficient.
This Cochrane Systematic Review aimed to investigate evidence on the effects of exercise-based cardiac rehabilitation on mortality, hospital admission, and health-related quality of life in people with heart failure compared to standard care. 
Forty-four studies involving a total of 5783 individuals were included. Current evidence shows that exercise-based cardiac rehabilitation improves health-related quality of life and reduces the risk of hospitalisation. These effects appear to be consistent across centre-based and home-based programmes, thus supporting the recommendation that exercise-based cardiac rehabilitation might be provided in both settings according to the patient’s preference. 
Future well-designed, randomised controlled trials are necessary to investigate costs and cost-effectiveness of alternative programmes of exercise-based cardiac rehabilitation.

Comment by Sara Laxe