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. 2023 Dec 19;15(1):173.
doi: 10.1186/s13102-023-00786-1.

Feasibility of preoperative and postoperative physical rehabilitation for cardiac surgery patients - a longitudinal cohort study

Sandra Dijkstra #  1 , Johanneke Hartog #  2 , Joke Fleer  3 , Pim van der Harst  4   5 , Lucas H V van der Woude  6   7 , Massimo A Mariani  2
Affiliations

Feasibility of preoperative and postoperative physical rehabilitation for cardiac surgery patients - a longitudinal cohort study

Sandra Dijkstra et al. BMC Sports Sci Med Rehabil. .

Abstract

Background: This study aimed to determine the feasibility of a preoperative and postoperative (in- and outpatient) physical rehabilitation program, the Heart-ROCQ-pilot program.

Methods: This cohort study included patients undergoing cardiac surgery (including coronary artery bypass graft surgery, valve surgery, aortic surgery, or combinations of these surgeries) and participated in the Heart-ROCQ-pilot program. Feasibility involved compliance and characteristics of bicycle and strength training sessions in the three rehabilitation phases.

Results: Of the eligible patients, 56% (n = 74) participated in the program (41% of exclusions were due to various health reasons). On average across the rehabilitation phases, the compliance rates of bicycle and strength training were 88% and 83%, respectively. Workload to heart rate (W/HR) ratio and total absolute volume load for bicycle and strength training, respectively, improved in each rehabilitation phase (P < 0.05). The W/HR-ratio was higher during the last postoperative session compared to the first preoperative session (0.48 to 0.63 W/beat, P < 0.001) and similar to the last preoperative session (0.65 to 0.64 W/beat, P < 0.497). During less than 1% of the bicycle sessions, patients reported discomfort scores of 5 to 6 (scale 0-10, with higher scores indicating a higher level).

Conclusions: The Heart-ROCQ-pilot program was feasible for patients awaiting cardiac surgery. Patients were very compliant and were able to safely increase the training load before surgery and regained this improvement within eight weeks after surgery.

Keywords: Cardiac surgical procedures; Coronary artery Disease; Endurance training; Ergometry; Observational study; Preoperative exercise; Therapeutics.

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Conflict of interest statement

SD, JH, and MAM report grants from “Stichting Beatrixoord Noord-Nederland”, Edwards Lifesciences SA, and Abbott (formerly St. Jude Medical Nederland B.V.). MAM reports consultancy from AtriCure, Getinge, and LivaNova. The remaining authors have nothing to disclose.

Figures

Fig. 1
Fig. 1
Overview of the physical elements of the Heart-ROCQ-pilot program. ↑: An increase; LE: lower extremities; Max-IP: Maximum inspiratory pressure; rep: repetitions; RM: repetition maximum; RPE: rate of perceived exertion (Borg scale 0–10); UE: upper extremities; VO2: oxygen uptake
Fig. 2
Fig. 2
Consort flow diagram of patients in- and excluded in the Heart-ROCQ-pilot program and drop-outs during the three rehabilitation phases
Fig. 3
Fig. 3
Number of bicycle (A) and strength (B) training sessions in the three rehabilitation phases according to the protocol, offered to and actually completed by the patients. n: number of patients; Ns: number of sessions
Fig. 4
Fig. 4
Training load of bicycle training at the first and last session of the three rehabilitation phases. (A) External workload, heart rate, and workload to heart rate ratio; (B) Rate of perceived exertion. Differences paired samples t-tests: *first vs. last session in a rehabilitation phase; #first session of PRE phase vs. last session of POST-out phase; +last session of PRE phase vs. last session of POST-out phase. a days (Median (IQR)) relative to the surgery
Fig. 5
Fig. 5
Absolute volume load (sets*repetitions*intensity) of the strength training at the first and last session of the three rehabilitation phases. Mean with upper limit of 95% confidence interval are shown. Differences of repeated measures analyses of all exercises (black), leg exercises (blue), and the arm exercises (orange): *first vs. last session in a rehabilitation phase; #first session of PRE phase vs. last session of POST-out phase; +last session of PRE phase vs. last session of POST-out phase. a days (Median (IQR)) relative to the surgery
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References

    1. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J, Corey P, et al. Prediction of long-term prognosis in 12 169 men referred for cardiac rehabilitation. Circulation. 2002;106:666–71. doi: 10.1161/01.CIR.0000024413.15949.ED. - DOI - PubMed
    1. Nery RM, Barbisan JN. Effect of leisure-time physical activity on the prognosis of coronary artery bypass graft Surgery. Rev Bras Cir Cardiovasc. 2010;25:73–8. doi: 10.1590/S0102-76382010000100016. - DOI - PubMed
    1. Ruiz-Núñez B, Pruimboom L, Dijck-Brouwer DAJ, Muskiet FAJ. Lifestyle and nutritional imbalances associated with western Diseases: causes and consequences of chronic systemic low-grade inflammation in an evolutionary context. J Nutr Biochem. 2013;24:1183–201. doi: 10.1016/j.jnutbio.2013.02.009. - DOI - PubMed
    1. Sampalis J, Boukas S, Liberman M, Reid T, Dupuis G. Impact of waiting time on the quality of life of patients awaiting coronary artery bypass grafting. CMAJ. 2001;165:429–33. - PMC - PubMed
    1. Arthur HM, Daniels C, McKelvie R, Hirsh J, Rush B. Effect of a preoperative intervention on preoperative and postoperative outcomes in low-risk patients awaiting elective coronary artery bypass graft Surgery: a randomized, controlled trial. Ann Intern Med. 2000;133:253–62. doi: 10.7326/0003-4819-133-4-200008150-00007. - DOI - PubMed

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