Clinical efficiency of prehabilitation program in patients undergoing coronary artery bypass grafting

Abstract

Aim.To evaluate clinical efficacy of high-intensity exercise training included in the prehabilitation program for elective coronary artery bypass grafting (CABG).Methods. 38 male patients were included in the study before on-pump CABG. After fulfilling the inclusion/exclusion criteria, patients were randomized into two groups: Group 1 patients (n = 20) underwent supervised treadmill exercise, and Group 2 patients (n = 18) were referred to surgery without any exercise training. Patients underwent a 7-day exercise training with daily measurements of hemodynamic parameters and electrocardiogram (ECG) monitoring. The load intensity was measured with cardiopulmonary exercise testing and accounted for 80% of the maximal oxygen uptake. Postoperative complications were recorded in the in-hospital period and analyzed. Quality of life indicators were measured by the SF-36 standard version 7–10 days prior to surgery and on days 7-10 of the postoperative period. Adherence to drug and non-drug therapy was assessed during the 6-month follow-up.Results.There was a significantly lower incidence of postoperative complications during the in-hospital period in patients undergoing prehabilitation program with supervised high-intensity exercise training, compared with patients without any exercise training (p = 0.002). Group 1 patients had reliably better mental health (MH) scores compared with Group 2 patients (48.9±7.60 vs. 39.1±6.80 scores, respectively; p = 0.03) on days 7–10 after CABG. Six months after the CABG, patients who underwent prehabilitation exercise training were less likely to resume smoking than patients without any exercise training (p = 0.04). The tendency towards improved adherence to drug therapy and compensation in arterial hypertension has been determined among Group 1 patients.Conclusion. Exercise training included in the prehabilitation program proved to be safe and effective in terms of improved clinical outcomes after CABG, quality of life and adherence to treatment in this group of patients.