Historically, patients with chronic heart failure (CHF) have been excluded from exercise training due to concerns regarding safety and lack of evidence that demonstrate improved health outcomes. As the incidence of chronic heart failure is dramatically increasing so is its already substantial economic burden on society. The purpose of this paper is to consider the efficacy of including exercise rehabilitation as part of the complete management of patients with CHF. A Medline and CINAHL search was undertaken to identify clinical randomised controlled trials using the terms chronic heart failure or congestive heart failure and exercise or physical training. The ten most recent trials that met criteria were then analysed. All trials had been undertaken outside of New Zealand. Subject populations had a general absence of females, the elderly, the most severe cases and minority cultures. There is increasing evidence that for a subsection of patients with CHF, namely those who are younger, male and white, the outcome measures of exercise capacity and quality of life can be significantly improved after an appropriate exercise programme. In addition, one large trial demonstrated a significant reduction in hospitalisation and mortality. None of the trials reported adverse events during the exercise sessions. There is now emerging evidence that exercise training is a safe intervention that has multiple positive outcomes on health for a sebsection of patients suffering from CHF. The challenge for physiotherapists is now to establish or enhance such programmes, and to undertake further research in a more diverse population.

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