Objectives This meta-analysis aims to (1) evaluate the efficacy of physical activity interventions in heart failure and (2) to identify intervention characteristics significantly associated with the interventions’ efficacy. Methods Randomised controlled trials reporting intervention effects on physical activity in heart failure were combined in a meta-analysis using a random-effect model. Exploratory meta-analysis was performed by specifying the general approach (eg, cardiac rehabilitation), strategies used (eg, action planning), setting (eg, centre based), mode of delivery (eg, face to face or online), facilitator (eg, nurse), contact time and behavioural change theory use as predictors in the random-effect model. Results Interventions (n=21) had a significant overall effect (SMD=0.54, 95% CI (0.13 to 0.95), p<0.0005). Combining an exercise programme with behavioural change intervention was found efficacious (SMD=1.26, 95% CI (0.26 to 2.26), p<0.05). Centre-based (SMD=0.98, 95% CI (0.35 to 1.62), and group-based (SMD=0.89, 95% CI (0.29 to 1.50),) delivery by a physiotherapist (SMD=0.84, 95% CI (0.03 to 1.65),) were significantly associated with efficacy. The following strategies were identified efficacious: prompts/cues (SMD=3.29, 95% CI (1.97 to 4.62)), credible source (standardised mean difference, SMD=2.08, 95% CI (0.95;3.22)), adding objects to the environment (SMD=1.47, 95% CI (0.41 to 2.53)), generalisation of the target behaviour SMD=1.32, 95% CI (0.22 to 2.41)), monitoring of behaviour by others without feedback (SMD=1.02, 95% CI (0.05 to 1.98)), self-monitoring of outcome(s) of behaviour (SMD=0.79, 95% CI (0.06 to 1.52), graded tasks (SMD=0.73, 95% CI (0.22 to 1.24)), behavioural practice/rehearsal (SMD=0.72, 95% CI (0.26 to 1.18)), action planning (SMD=0.62, 95% CI (0.03 to 1.21)) and goal setting (behaviour) (SMD=0.56, 95% CI (0.03 to 1.08)). Conclusion The meta-analysis suggests intervention characteristics that may be suitable for promoting physical activity in heart failure. There is moderate evidence in support of an exercise programme combined with a behavioural change intervention delivered by a physiotherapist in a group-based and centre-based settings. PROSPERO registeration CRD42015015280. All data relevant to the study are included in the article or uploaded as online supplemental information.

中文翻译：

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增加心力衰竭患者体力活动的干预措施的有效性：荟萃分析

目标 本荟萃分析旨在 (1) 评估体力活动干预对心力衰竭的疗效，以及 (2) 确定与干预效果显着相关的干预特征。方法 使用随机效应模型将报告干预对心力衰竭体力活动影响的随机对照试验合并到荟萃分析中。探索性荟萃分析通过指定一般方法（例如心脏康复）、使用的策略（例如行动计划）、设置（例如，基于中心）、交付方式（例如，面对面或在线）、促进者（例如，护士）、接触时间和行为改变理论在随机效应模型中用作预测变量。结果 干预 (n=21) 具有显着的总体效果（SMD=0.54，95% CI（0.13 至 0.95），p<0.0005）。发现将锻炼计划与行为改变干预相结合是有效的（SMD=1.26，95% CI（0.26 至 2.26），p<0.05）。基于中心（SMD=0.98，95% CI（0.35 至 1.62）和基于组（SMD=0.89，95% CI（0.29 至 1.50））由物理治疗师（SMD=0.84，95% CI（0.03）至 1.65),) 与疗效显着相关。以下策略被确定为有效：提示/提示（SMD=3.29，95% CI（1.97 至 4.62）），可靠来源（标准化平均差，SMD=2.08，95% CI (0.95;3.22))，向环境中添加对象（SMD=1.47, 95% CI (0.41 to 2.53))，目标行为的泛化 SMD=1.32, 95% CI (0.22 to 2.41)），通过其他没有反馈 (SMD=1.02, 95% CI (0.05 to 1.98)), 自我监测行为结果 (SMD=0.79, 95% CI (0.06 to 1.52), 分级任务 (SMD=0.73, 95% CI（0.22 至 1.24））、行为练习/排练（SMD=0.72、95% CI（0.26 至 1.18））、行动计划（SMD=0.62、95% CI（0.03 至 1.21））和目标设定（行为) (SMD=0.56, 95% CI (0.03 to 1.08))。结论 荟萃分析表明可能适合促进心力衰竭患者身体活动的干预特征。有中等证据支持运动计划与物理治疗师在团体和中心环境中提供的行为改变干预相结合。PROSPERO 注册 CRD42015015280。与研究相关的所有数据都包含在文章中或作为在线补充信息上传。03 至 1.08))。结论 荟萃分析表明可能适合促进心力衰竭患者身体活动的干预特征。有中等证据支持运动计划与物理治疗师在团体和中心环境中提供的行为改变干预相结合。PROSPERO 注册 CRD42015015280。与研究相关的所有数据都包含在文章中或作为在线补充信息上传。03 至 1.08))。结论 荟萃分析表明可能适合促进心力衰竭患者身体活动的干预特征。有中等证据支持运动计划与物理治疗师在团体和中心环境中提供的行为改变干预相结合。PROSPERO 注册 CRD42015015280。与研究相关的所有数据都包含在文章中或作为在线补充信息上传。