title: Cardiac rehabilitation for people with heart disease: an overview of Cochrane systematic reviews.
abstract: BACKGROUND
  Overviews are a new approach to summarising evidence and synthesising results from related systematic reviews.
  
  
  OBJECTIVE
  To conduct an overview of Cochrane systematic reviews to provide a contemporary review of the evidence for cardiac rehabilitation (CR), identify opportunities for merging or splitting existing Cochrane reviews, and identify current evidence gaps to inform new review titles.
  
  
  METHODS
  The Cochrane Database of Systematic Reviews was searched to identify reviews that address the objectives of this overview. Data presentation is descriptive with tabular presentations of review- and trial-level characteristics and results.
  
  
  RESULTS
  The six included Cochrane systematic reviews were of high methodological quality and included 148 randomised controlled trials in 97,486 participants. Compared to usual care alone, exercise-based CR reduces hospital admissions and improves patient health related quality of life (HRQL) in low to moderate risk heart failure and coronary heart disease (CHD) patients. At 12 months or more follow-up, there was evidence of some reduction in mortality in patients with CHD. Psychological- and education-based interventions appear to have little impact on mortality or morbidity but may improve HRQL. Home- and centre-based programmes are equally effective in improving HRQL at similar costs. Selected interventions can increase the uptake of CR programmes but evidence to support interventions that improve adherence is weak.
  
  
  CONCLUSIONS
  This overview confirms that exercise-based CR is effective and safe in the management of clinically stable heart failure and post-MI and PCI patients. We discuss the implications of this overview on the future direction of the Cochrane CR reviews portfolio.
authors.affiliation: Exeter Cochrane Cardiac Rehabilitation Review Group, Institute of Health Research, University of Exeter Medical School, Exeter EX2 4SG, United Kingdom.
authors.forename: L J
authors.initials: LJ
authors.lastname: Anderson
authors.affiliation: Exeter Cochrane Cardiac Rehabilitation Review Group, Institute of Health Research, University of Exeter Medical School, Exeter EX2 4SG, United Kingdom. Electronic address: r.taylor@exeter.ac.uk.
authors.forename: R S
authors.initials: RS
authors.lastname: Taylor
mesh_terms: D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation; D005081:Exercise Therapy / Q000379:methods; D006331:Heart Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation*; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012196:Review Literature as Topic
keywords: Cardiac rehabilitation; Exercise training; Heart disease; Systematic reviews