Practice Recommendations Development Group

# The Author(s) 2013. This article is published with open access at Springerlink.com Background To improve the quality of exercise-based cardiac rehabilitation (CR) in patients with coronary heart disease (CHD) the CR guideline from the Dutch Royal Society for Physiotherapists (KNGF) has been updated. This guideline can be considered an addition to the 2011 Dutch Multidisci-plinary CR guideline, as it includes several novel topics. Methods A systematic literature search was performed to formulate conclusions on the efficacy of exercise-based inter-ventions during all CR phases in patients with CHD. Evidence was graded (1–4) according theDutch evidence-based guideline development (EBRO) criteria. In case of insufficient scientific evidence, recommendations were based on expert opinion. This guideline comprised a structured approach including assess-ment, treatment and evaluation. Results Recommendations for exercise-based CR were for-mulated covering the following topics: preoperative physio-therapy, mobilisation during the clinical phase, aerobic exer-cise, strength training, and relaxation therapy during the out-patient rehabilitation phase, and adoption and monitoring of a physically active lifestyle after outpatient rehabilitation. Conclusions There is strong evidence for the effectiveness of exercise-based CR during all phases of CR. The implementa-tion of this guideline in clinical practice needs further evalu-ation as well as the maintenance of an active lifestyle after supervised rehabilitation