Prehabilitation in patients awaiting elective coronary artery bypass graft surgery - effects on functional capacity and quality of life: a randomized controlled trial

Carolin Steinmetz, Birna Bjarnason-Wehrens, Heike Baumgarten, Thomas Walther, Thomas Mengden, Claudia Walther, Carolin Steinmetz, Birna Bjarnason-Wehrens, Heike Baumgarten, Thomas Walther, Thomas Mengden, Claudia Walther

Abstract

Objective: To determine the impact of an exercise-based prehabilitation (EBPrehab) program on pre- and postoperative exercise capacity, functional capacity (FC) and quality of life (QoL) in patients awaiting elective coronary artery bypass graft surgery (CABG).

Design: A two-group randomized controlled trail.

Setting: Ambulatory prehabilitation.

Subjects: Overall 230 preoperative elective CABG-surgery patients were randomly assigned to an intervention (IG, n = 88; n = 27 withdrew after randomization) or control group (CG, n = 115).

Intervention: IG: two-week EBPrehab including supervised aerobic exercise. CG: usual care.

Main measures: At baseline (T1), one day before surgery (T2), at the beginning (T3) and at the end of cardiac rehabilitation (T4) the following measurements were performed: cardiopulmonary exercise test, six-minute walk test (6MWT), Timed-Up-and-Go Test (TUG) and QoL (MacNew questionnaire).

Results: A total of 171 patients (IG, n = 81; CG, n = 90) completed the study. During EBPrehab no complications occurred. Preoperatively FC (6MWTIG: 443.0 ± 80.1 m to 493.5 ± 75.5 m, P = 0.003; TUGIG: 6.9 ± 2.0 s to 6.1 ± 1.8 s, P = 0.018) and QoL (IG: 5.1 ± 0.9 to 5.4 ± 0.9, P < 0.001) improved significantly more in IG compared to CG. Similar effects were observed postoperatively in FC (6MWDIG: Δ-64.7 m, pT1-T3 = 0.013; Δ+47.2 m, pT1-T4 < 0.001; TUGIG: Δ+1.4 s, pT1-T3 = 0.003).

Conclusions: A short-term EBPrehab is effective to improve perioperative FC and preoperative QoL in patients with stable coronary artery disease awaiting CABG-surgery.ID: NCT04111744 (www.ClinicalTrials.gov; Preoperative Exercise Training for Patients Undergoing Coronary Artery Bypass Graft Surgery- A Prospective Randomized Trial).

Keywords: Coronary artery disease; aerobic exercise; cardiac rehabilitation; coronary artery bypass surgery; quality of life.

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The defined study timepoints. CABG: Coronary artery bypass graft.
Figure 2.
Figure 2.
Study flow chart. CABG: Coronary artery bypass graft; T1: Baseline; T2: One day before surgery; T3: Beginning of cardiac rehabilitation; T4: End of cardiac rehabilitation; OP: Operation; MI: Myocardinfarction.

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Source: PubMed

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