Chronic heart failure (CHF) is defined as ‘a complex of signs and symptoms associated with a structural or functional abnormality of the heart’.

CHF involves peripheral and central changes resulting in reduced exercise capacity. The most frequent causes of CHF are hypertension and coronary artery disease; less frequent causes include heart valve diseases, arrhythmias and viral infections. The prevalence and incidence of CHF increases with age, and has an adverse overall prognosis with a 5-year mortality rate of 45 %. In Dutch CR centres, there is considerable variation in the methods for determination of exercise intensity training, training intensity and volume.

This guideline outlines best practice standards for physiotherapists concerning exercise-based CR in CHF patients. An extensive literature search was performed to assess efficacy of CR in all phases (clinical, outpatient and post-CR).