Prehabilitation program for elective coronary artery bypass graft surgery patients: a pilot randomized controlled study.
OBJECTIVE
To determine the feasibility of a cardiac prehabilitation (Prehab) program for patients waiting for elective coronary artery bypass graft (CABG).


METHODS
A two-group parallel randomized controlled trial.


METHODS
Medical fitness facility.


METHODS
Seventeen preoperative elective CABG surgery patients were randomized to standard care (n = 9) or Prehab (n = 8).


METHODS
Standard care: three-hour preassessment appointment. Prehab: exercise and education classes for 60 minutes/day, twice weekly for at least four weeks.


METHODS
Data were collected at baseline, one week preoperatively, and three months postoperatively. The primary outcome measure was walking distance using a 6-minute walk test. Secondary outcome variables included 5-meter gait speed, and cardiac rehabilitation attendance three months postoperatively.


RESULTS
Fifteen patients (standard care, n = 7; Prehab, n = 8) completed the study. No Prehab patients developed cardiac symptoms during study participation. Walking distance remained unchanged in the standard care group; whereas, the Prehab group increased their walking distance to mean ± SD 474 ±101 and 487 ±106 m at the preoperative and three month postoperative assessments (p < 0.05). Gait speed was unchanged in the standard care group, but improved in the Prehab group by 27% and 33% preoperatively and three months postoperatively, respectively (p < 0.05). Enrollment in cardiac rehabilitation three months postoperatively was higher for Prehab participants (100%) than standard care participants (43%; p < 0.05).


CONCLUSIONS
These data provide evidence for the feasibility of a Prehab intervention to improve the health status of patients waiting for elective CABG surgery. A larger trial of 92 patients will be utilized to demonstrate the safety and efficacy of Prehab.
Faculty of Nursing, University of Manitoba, Winnipeg, Canada.
Jo-Ann V
JA
Sawatzky
Health, Leisure, and Human Performance Research Institute, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada Institute of Cardiovascular Sciences, St. Boniface Hospital Research Centre, Winnipeg, Canada.
D Scott
DS
Kehler
Health, Leisure, and Human Performance Research Institute, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada.
A Elizabeth
AE
Ready
Reh-Fit Centre, Winnipeg, Canada.
Neal
N
Lerner
Reh-Fit Centre, Winnipeg, Canada.
Sue
S
Boreskie
Reh-Fit Centre, Winnipeg, Canada.
Darlene
D
Lamont
Reh-Fit Centre, Winnipeg, Canada.
Dean
D
Luchik
Department of Surgery (Cardiac Surgery), University of Manitoba, Winnipeg, Canada.
Rakesh C
RC
Arora
Health, Leisure, and Human Performance Research Institute, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada Institute of Cardiovascular Sciences, St. Boniface Hospital Research Centre, Winnipeg, Canada Department of Physiology, University of Manitoba, Winnipeg, Canada tduhamel@sbrc.ca.
Todd A
TA
Duhamel
D000368:Aged; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000534:rehabilitation* / Q000601:surgery*; D017558:Elective Surgical Procedures; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011300:Preoperative Care; D012046:Rehabilitation / Q000379:methods*; D016896:Treatment Outcome
Coronary artery bypass; exercise therapy; pre-habilitation