Hirschhorn Andrew D, Richards David A B, Mungovan Sean F, Morris Norman R, Adams Lewis
Westmead Private Physiotherapy Services, NSW, Australia.
Interact Cardiovasc Thorac Surg. 2012 Dec;15(6):995-1003. doi: 10.1093/icvts/ivs403. Epub 2012 Sep 12.
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.
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.
There were no significant differences between intervention groups at hospital discharge for 6-min walk distance (cyclists: 402 ± 93 m vs walkers: 417 ± 86 m, P = 0.803), 6-min cycle work (cyclists: 15.0 ± 6.4 kJ vs 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 vs walkers: 199/242 (82%) scheduled exercise sessions completed (P = 0.162).
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).
本研究旨在比较初次冠状动脉搭桥手术后早期进行中等强度固定自行车运动和步行运动计划的效果。
在这项前瞻性试验中，64例患者（57例男性，7例女性，平均年龄=66±9岁）从术后第3天开始至出院，每天进行两次，每次持续10分钟的中等强度运动。患者被随机分配到固定自行车运动或步行运动干预组。术前和出院时的功能运动能力及健康相关生活质量通过6分钟步行和骑行评估以及SF-36第2.0版问卷进行评估。运动依从性以完成的预定运动课程比例计算。
出院时，干预组之间在6分钟步行距离（骑自行车者：402±93米，步行者：417±86米，P = 0.803）、6分钟骑行工作量（骑自行车者：15.0±6.4千焦，步行者：14.0±6.3千焦，P = 0.798）或健康相关生活质量方面无显著差异。干预组之间术后住院时间无显著差异（P = 0.335）。干预组的依从率为：骑自行车者完成185/246（75%）的预定运动课程，步行者完成199/242（82%）的预定运动课程（P = 0.162）。
在冠状动脉搭桥手术后早期，固定自行车运动是一种耐受性良好且临床有效的步行替代运动。术后早期运动的最佳频率、强度和持续时间需要进一步研究。（临床试验注册：澳大利亚新西兰临床试验注册中心；识别号：ACTRN12608000359336；http://www.anzctr.org.au/trial_view.aspx?ID=82978）
