What evidence is there to support the recommendation of a structured, exercise-based cardiac rehabilitation program for patients with recent occurrence of coronary heart disease?
The Work Group systematically reviewed evidence related to this recommendation.[134-142] The Work Group's confidence in the quality of the evidence was very low. The body of evidence had significant methodologic limitations. The potential large benefit on mortality would appear to outweigh the risk of musculoskeletal injury. Although feasibility and resource requirements might be a concern with higher activity levels for some patients, this would not apply to lower intensity activities. Therefore, this recommendation broadens acceptability and feasibility to patients who are unable to achieve the traditional moderate to vigorous intensity physical activity recommendations. Thus, the Work Group decided upon a Weak for recommendation. Research utilizing randomization and more accurate methods of measuring physical activity levels are needed to improve confidence in the effect of physical activity on CV outcomes in both primary and secondary prevention populations.