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

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)

Análise Do Índice De Hiperóxia Em Adultos Na Unidade De Terapia Intensiva Em Hospital Universitário No Estado De São Paulo

“…Dos quatro artigos selecionados, um tratava-se de uma pesquisa de intervenção sem grupo controle (GIMENO-SANTOS et al, 2019), e três eram Ensaios Clínicos com grupo controle (SAWATZKY et al, 2014;STEINMETZ et al, 2020;MOSTAFA et al, 2020).…”

“…Ainda sim, um estudo incluiu pacientes em espera de transplante cardíaco (GIMENO-SANTOS et al, 2019), e os demais elegeram indivíduos no pré-operatório de revascularização do miocárdio (SAWATZKY et al, 2014;STEINMETZ et al, 2020) e/ou substituição valvar (MOSTAFA et al, 2020). No que se refere aos objetivos, dois estudos avaliaram a viabilidade da PR (SAWATZKY et al, 2014;GIMENO-SANTOS et al, 2019), enquanto outros dois investigaram seus efeitos (STEINMETZ et al, 2020;MOSTAFA et al, 2020). Fonte: Dados da pesquisa (2020).…”

Determining Factors for Independent Walking in Patients Undergoing Cardiovascular Surgery: Differences between Coronary Artery Bypass Grafting, Heart Valve Surgery, and Aortic Surgery

“…These results suggest that aortic surgery, compared with other cardiac surgeries, is more likely to interfere with post-operative recovery. As an approach to early recovery of physical functions, it has been reported that interventions such as pre-operative rehabilitation and pre-operative education are effective in improving post-operative physical and mental functions in CABG and valve surgery [34][35][36]. However, because aortic surgery often involves emergency surgery associated with aneurysm rupture or dissection and because there is a risk of rupture even in cases that are asymptomatic and discovered incidentally [37], it is often impossible to take measures such as rehabilitation intervention pre-operatively.…”

Efeito Do Método Pilates Na Mobilidade Funcional Em Pacientes Com Parkinson

“…Portanto, essa estratégia facilitou a estruturação desta pesquisa e a formulação do seguinte questionamento: "Quais são as evidências científicas existentes sobre a efetividade da PR nos desfechos pré e pós-operatórios de pacientes submetidos à cirurgia cardíaca?". A fim de se encontrar respostas, foi realizada uma revisão integrativa da literatura, em julho de 2020, a partir da leitura de artigos identificados nas bases de dados Dos quatro artigos selecionados, um tratava-se de uma pesquisa de intervenção sem grupo controle (GIMENO-SANTOS et al, 2019), e três eram Ensaios Clínicos com grupo controle (SAWATZKY et al, 2014;STEINMETZ et al, 2020;MOSTAFA et al, 2020).…”

“…Com relação ao ano de publicação, variou entre 2014 e 2020. Ainda sim, um estudo incluiu pacientes em espera de transplante cardíaco (GIMENO-SANTOS et al, 2019), e os demais elegeram indivíduos no pré-operatório de revascularização do miocárdio (SAWATZKY et al, 2014;STEINMETZ et al, 2020) e/ou substituição valvar (MOSTAFA et al, 2020). No que se refere aos objetivos, dois estudos avaliaram a viabilidade da PR (SAWATZKY et al, 2014;GIMENO-SANTOS et al, 2019), enquanto outros dois investigaram seus efeitos (STEINMETZ et al, 2020;MOSTAFA et al, 2020).…”