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Does the mode of exercise influence recovery of functional capacity in the early postoperative period after coronary artery bypass graft surgery? A randomized controlled trial
Hirschhorn AD, Richards DAB, Mungovan SF, Morris NR, Adams L
Interactive Cardiovascular and Thoracic Surgery 2012 Dec;15(6):995-1003
clinical trial
9/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: Yes; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: The purpose of this study was to compare the effectiveness of moderate-intensity stationary cycling and walking exercise programmes in the early postoperative period after first-time coronary artery bypass graft surgery. METHODS: In this prospective trial, 64 patients (57 men, 7 women, mean age 66 +/- 9 years) performed twice daily, moderate-intensity exercise sessions, of 10-min duration, from postoperative day 3 until discharge from hospital. Patients were randomly assigned to stationary cycling or walking exercise intervention groups. Preoperative and discharge functional exercise capacity and health-related quality of life were assessed using 6-min walk and cycle assessments and the SF-36 version 2.0 questionnaire. Compliance with exercise was calculated as the proportion of scheduled exercise sessions completed. RESULTS: There were no significant differences between intervention groups at hospital discharge for 6-min walk distance (cyclists 402 +/- 93 m versus walkers 417 +/- 86 m, p = 0.803), 6-min cycle work (cyclists 15.0 +/- 6.4 kJ versus walkers 14.0 +/- 6.3 kJ, p = 0.798) or health-related quality of life. There was no significant difference between intervention groups for postoperative length of hospital stay (p = 0.335). Compliance rates for intervention groups were cyclists 185/246 (75%) scheduled exercise sessions completed versus walkers 199/242 (82%) scheduled exercise sessions completed (p = 0.162). CONCLUSIONS Stationary cycling provides a well-tolerated and clinically effective alternative to walking in the early postoperative period after coronary artery bypass graft surgery. The optimal frequency, intensity and duration of exercise in the early postoperative period require further investigation. (CLINICAL TRIALS REGISTER: Australian New Zealand Clinical Trials Registry; identification number ACTRN12608000359336; http://www.anzctr.org.au/trial_view.aspx?ID=82978).

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