title: Early physical training and psycho-educational intervention for patients undergoing coronary artery bypass grafting. The SheppHeart randomized 2 × 2 factorial clinical pilot trial.
abstract: Patients undergoing coronary artery bypass graft surgery often experience a range of problems and symptoms such as immobility, pain and insufficient sleep. Results from trials investigating testing in-hospital physical exercise or psychological intervention have been promising. However, no randomized clinical trials have tested a comprehensive rehabilitation programme consisting of both physical exercise and psycho-education in the early rehabilitation phase.
  
  
  
  The aims of the present SheppHeart pilot randomized clinical trial were to evaluate the feasibility of patient recruitment, patient acceptance of the intervention, safety and tolerability of the intervention.
  
  
  
  Sixty patients admitted for coronary artery bypass graft were randomized 1:1:1:1 to: 1) physical exercise plus usual care, or 2) psycho-educational intervention plus usual care, or 3) physical exercise and psycho-educational plus usual care, or 4) usual care alone during a four week period after surgery.
  
  
  
  The acceptability of trial participation was 67% during the three month recruitment period. In the physical exercise groups, patients complied with 59% of the total expected training sessions during hospitalization. Nine patients (30%) complied with >75% and nine patients (30%) complied with 50% of the planned exercise sessions. Eleven patients (42%) participated in ⩾75% of the four consultations and six patients (23%) participated in 50% of the psycho-educational programme.
  
  
  
  Comprehensive phase one rehabilitation combining physical exercise and psycho-education in coronary artery bypass graft patients shows reasonably high inclusion, feasibility and safety.
authors.affiliation: Thoracic Clinic, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Denmark ida.elisabeth.hoejskov@regionh.dk.
authors.forename: Ida E
authors.initials: IE
authors.lastname: Højskov
authors.affiliation: KU Leuven - University of Leuven Department of Public Health and Primary Care, KU Leuven, Belgium.
authors.forename: Philip
authors.initials: P
authors.lastname: Moons
authors.affiliation: The Centre for Research in Existence and Society, University of Copenhagen, Denmark.
authors.forename: Niels V
authors.initials: NV
authors.lastname: Hansen
authors.affiliation: Thoracic Clinic, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Denmark.
authors.forename: Helle
authors.initials: H
authors.lastname: Greve
authors.affiliation: Thoracic Clinic, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Denmark.
authors.forename: Dorte Bæk
authors.initials: DB
authors.lastname: Olsen
authors.affiliation: The Centre for Research in Existence and Society, University of Copenhagen, Denmark.
authors.forename: Søren La
authors.initials: SL
authors.lastname: Cour
authors.affiliation: Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Glud
authors.affiliation: Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Denmark.
authors.forename: Per
authors.initials: P
authors.lastname: Winkel
authors.affiliation: Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Denmark.
authors.forename: Jane
authors.initials: J
authors.lastname: Lindschou
authors.affiliation: Trauma Centre, Rigshospitalet, Copenhagen University Hospital, Denmark.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Egerod
authors.affiliation: Thoracic Clinic, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Denmark.
authors.forename: Anne Vinggaard
authors.initials: AV
authors.lastname: Christensen
authors.affiliation: Thoracic Clinic, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Denmark.
authors.forename: Selina Kikkenborg
authors.initials: SK
authors.lastname: Berg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000523:psychology*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology / Q000534:rehabilitation* / Q000601:surgery*; D011613:Psychotherapy; D013315:Stress, Psychological / Q000628:therapy*
keywords: Phase one rehabilitation; coronary artery bypass grafting; physical exercise; psycho-education