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Prehabilitation in patients awaiting elective coronary artery bypass graft surgery -- effects on functional capacity and quality of life: a randomized controlled trial [with consumer summary] |
Steinmetz C, Bjarnason-Wehrens B, Baumgarten H, Walther T, Mengden T, Walther C |
Clinical Rehabilitation 2020 Oct;34(10):1256-1267 |
clinical trial |
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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 delta -64.7 m, p[T1-T3] = 0.013; delta +47.2 m, p[T1-T4] < 0.001; TUGIG delta +1.4 s, p[T1-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).
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