Samenvatting

Rationale To improve the quality of exercise-based cardiac
rehabilitation (CR) in patients with chronic heart failure
(CHF) a practice guideline from the Dutch Royal Society for
Physiotherapy (KNGF) has been developed.
Guideline development A systematic literature search was
performed to formulate conclusions on the efficacy of
exercise-based intervention during all CR phases in
patients with CHF. Evidence was graded (1–4) according
the Dutch evidence-based guideline development
criteria.
Clinical and research recommendations Recommendations
for exercise-based CR were formulated covering the
following topics: mobilisation and treatment of pulmonary
symptoms (if necessary) during the clinical phase,
aerobic exercise, strength training (inspiratory muscle
training and peripheral muscle training) and relaxation
therapy during the outpatient CR phase, and adoption
and monitoring training after outpatient CR.
Applicability and implementation issues This guideline provides
the physiotherapist with an evidence-based instrument
to assist in clinical decision-making regarding patients with
CHF. The implementation of the guideline in clinical practice
needs further evaluation.
Conclusion This guideline outlines best practice standards for
physiotherapists concerning exercise-based CR in CHF patients.
Research is needed on strategies to improve monitoring
and follow-up of the maintenance of a physical active lifestyle
after supervised CR.