Effects of Different Rehabilitation Protocols in Inpatient Cardiac Rehabilitation After Coronary Artery Bypass Graft Surgery: A RANDOMIZED CLINICAL TRIAL. Issue 6 (November 2019)

• Record Type: Journal Article
• Authors: Zanini, Maurice; Nery, Rosane Maria; de Lima, Juliana Beust; Buhler, Raquel Petry; da Silveira, Anderson Donelli; Stein, Ricardo
• Is Part Of: Journal of cardiopulmonary rehabilitation and prevention. Volume 39:Issue 6(2019)
• Publication Date: 2019-11
• Subjects: exercise -- functional capacity -- lung capacity -- rehabilitation; Cardiopulmonary system -- Diseases -- Patients -- Rehabilitation -- Periodicals; Cardiopulmonary system -- Diseases -- Prevention -- Periodicals; 616.103
• DOI: 10.1097/HCR.0000000000000431
• Languages: English
• ISSNs: 1932-7501

Abstract

Abstract : Purpose: Patients undergoing coronary artery bypass graft (CABG) surgery typically experience loss of cardiopulmonary capacity in the post-operative period. The purpose of this study was to evaluate the effects of different rehabilitation protocols used in inpatient cardiac rehabilitation on functional capacity and pulmonary function in patient status post-CABG surgery. Methods: This was a single-blind randomized controlled trial. The primary endpoint of functional capacity and secondary endpoints of lung capacity and respiratory muscle function were assessed in patients scheduled to undergo CABG. After surgery, 40 patients were randomly assigned across 1 of 4 inpatient cardiac rehabilitation groups: G1, inspiratory muscle training, active upper limb and lower limb exercise training, and early ambulation; G2, same protocol as G1 without inspiratory muscle training; G3, inspiratory muscle training alone; and G4, control. All groups received chest physical therapy and expiratory positive airway pressure. Patients were reassessed on post-operative day 6 and post-discharge day 30 (including cardiopulmonary exercise testing). Results: The 6-min walk distance on post-operative day 6 was significantly higher in groups that included exercise training (G1 and G2), remaining higher at 30 d post-discharge ( P < .001 between groups). Peak oxygen uptake on day 30 was also higher in G1 and G2 ( P = .005). All groups achieved similar recovery of lung function. Conclusion: Protocols G1 and G2, which included a systematic plan for early ambulation and upper and lower limb exercise, attenuated fitness losses while in the hospital and significantly enhanced recovery 1 mo after CABG. Abstract : Supplemental Digital Content is Available in the Text.Four different rehabilitation protocols were studied for patients early post-CABG surgery. The clinical relevance of our findings lies in the identification of which post-CABG rehabilitation protocols can provide a significant increase in functional capacity and, thus, aid in the early recovery of patients whose ability for physical activities is greatly limited.