Six-year follow-up of a randomised controlled trial examining hospital versus home-based exercise training after coronary artery bypass graft surgery. Issue 14 (10th May 2011)

• Record Type: Journal Article
• Authors: Smith, Kelly M; McKelvie, Robert S; Thorpe, Kevin E; Arthur, Heather M
• Is Part Of: Heart. Volume 97:Issue 14(2011)
• Page Start: 1169
• Page End: 1174
• Publication Date: 2011-05-10
• Subjects: Coronary artery bypass graft surgery -- cardiac rehabilitation -- exercise training -- randomised controlled trial -- long-term follow-up -- exercise training -- cardiac rehabilitation -- delivery of care; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2010.202036
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objective: To compare the long-term effectiveness of hospital versus telephone-monitored home-based exercise training during cardiac rehabilitation (CR) on exercise capacity and habitual physical activity. Design: Six-year follow-up of patients who participated in a randomised controlled trial of hospital versus monitored home-based exercise training during CR after coronary artery bypass graft surgery. Setting: Outpatient CR centre in Central-South Ontario, Canada. Participants: 196 Patients who participated in the original randomised controlled trial and who attended an evaluation 1 year after CR. Interventions: 6 months of home or hospital-based exercise training during CR. Main outcome measures: Peak oxygen uptake (peak Vo 2 ), Physical Activity Scale in the Elderly (PASE) to assess habitual activity, semi-structured interviews to assess vital status, demographic and descriptive information. Results: Of the 196 eligible patients, 144 (75.5%; 74 Hospital, 70 Home) were available for participation. Patients were predominantly male (n=120; 83.3%) aged 70±9.5 years. Clinical and sociodemographic outcomes were similar in both groups. While exercise performance declined over time, there were significant between-group differences in peak Vo 2 (1506±418 ml/min vs 1393±341 ml/min; p=0.017) and PASE scores (166.7±90.2 vs 139.7±66.5; p=0.001) at 6-year follow-up in favour of the home group. Conclusions: Home and hospital-based exercise training maintained exercise capacity above pre-CR levels 6 years after CR. Exercise training initiated in the home environment in low-risk patients undergoing coronary artery bypass graft surgery conferred greater long-term benefit on Vo 2 and persistent physical activity compared with traditional hospital-based CR.