Therefore, the effects of resistance training, either alone or in combination with aerobic training, in people with chronic heart failure remain unclear. Therefore the following research BIBW2992 cost questions for this study focused on people with heart failure: 1. Does resistance training

improve heart function, exercise capacity and quality of life in people with chronic heart failure more than no intervention or usual care? Six electronic databases (PubMed, MEDLINE, EMBASE, Chinese Electronic Periodical Service [CEPS], CINAHL, and Cochrane Library Register of Controlled Trials) were searched from the earliest available date until September 2009. We hand-searched reference lists of all identified original articles, previous meta-analyses and reviews. Experts were asked to identify any other relevant trials known to them. The following keywords and Medical Subject Heading (MeSH) terms were used in our searches: heart failure, heart dysfunction, ventricular dysfunction, resistance training, strength exercise, strength training, weight-lifting, and weight

training (see Appendix 1 on the eAddenda for the full search strategy). Published randomised trials limited to human subjects were considered. Articles written in languages other Metabolism inhibitor than English or Chinese were excluded. Two reviewers (CLH and CLC) reviewed the trials using predetermined criteria independently (Box 1). Reviewers were not blinded to authors, place of publication, or results. Design • Randomised trial Participants • Adults with chronic heart failure Intervention • Progressive resistance exercise training, with training defined as a structured, hospital- or home-based program with a target exercise type, intensity, duration and frequency, and with regular measurement of whether these were achieved Outcome measures • Cardiac function Comparisons • Progressive resistance exercise training versus no training or usual care or sham exercise Quality: All trials were critically appraised for methodological quality using the PEDro Scale (0 to 10, Maher et al 2003, de Morton, 2009) by two reviewers (CLH

and CLC). Any disagreements were resolved by discussion with another reviewer (YTW). Participants: Age, gender, Dichloromethane dehalogenase and cause and severity of chronic heart failure were recorded to determine the similarity of participants between groups and between trials. Intervention: The target intensity, duration, and frequency of exercise and the length of the intervention period were recorded. For the study question assessing the effect of resistance training alone, the control was categorised as no intervention, usual activity or sham exercise. For the study question assessing the effect of combined training versus aerobic training alone, the target intensity, duration, and frequency of aerobic exercise were also recorded.