title: Effect of outpatient exercise training  programmes in patients with chronic  heart failure: a systematic review.
abstract: BACKGROUND
  Advantages of outpatient exercise training are reduced waiting lists, better compliance, reduced time investment by the patient with reduced travel expenses, and less dependence on other people to participate. Therefore, this systematic review studies the effects of outpatient exercise training programmes compared with usual care on exercise capacity, exercise performance, quality of life, and safety in patients with chronic heart failure.
  
  
  METHODS
  Systematic review with meta-analysis.
  
  
  METHODS
  Randomized controlled trials concerning patients with chronic heart failure, with a left ventricular ejection fraction ≤40%, were included. A meta-analysis was performed.
  
  
  RESULTS
  Twenty-two studies were included. VO(2)max, 6-min walking test, and quality of life showed significant differences in favour of the intervention group of 1.85 ml/kg/min, 47.9 m, and 6.9 points, respectively. In none of the studies, a significant relationship was found between exercise training and adverse events.
  
  
  CONCLUSIONS
  This meta-analysis illustrates the efficacy and safety of outpatient training programmes for patients with chronic heart failure.
authors.affiliation: Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, The Netherlands.
authors.forename: Suzan
authors.initials: S
authors.lastname: van der Meer
authors.forename: Marlies
authors.initials: M
authors.lastname: Zwerink
authors.forename: Marco
authors.initials: M
authors.lastname: van Brussel
authors.forename: Paul
authors.initials: P
authors.lastname: van der Valk
authors.forename: Elly
authors.initials: E
authors.lastname: Wajon
authors.forename: Job
authors.initials: J
authors.lastname: van der Palen
mesh_terms: D000368:Aged; D000553:Ambulatory Care; D002908:Chronic Disease; D005080:Exercise Test; D005081:Exercise Therapy / Q000009:adverse effects; D017079:Exercise Tolerance; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011788:Quality of Life; D020127:Recovery of Function; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left