Sawatzky Jo-Ann V, Kehler D Scott, Ready A Elizabeth, Lerner Neal, Boreskie Sue, Lamont Darlene, Luchik Dean, Arora Rakesh C, Duhamel Todd A
Faculty of Nursing, University of Manitoba, Winnipeg, Canada.
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.
Clin Rehabil. 2014 Jul;28(7):648-57. doi: 10.1177/0269215513516475. Epub 2014 Jan 23.
To determine the feasibility of a cardiac prehabilitation (Prehab) program for patients waiting for elective coronary artery bypass graft (CABG).
A two-group parallel randomized controlled trial.
Medical fitness facility.
Seventeen preoperative elective CABG surgery patients were randomized to standard care (n = 9) or Prehab (n = 8).
Standard care: three-hour preassessment appointment. Prehab: exercise and education classes for 60 minutes/day, twice weekly for at least four weeks.
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.
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).
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.
确定为等待择期冠状动脉搭桥术（CABG）的患者开展心脏康复前训练（Prehab）项目的可行性。
两组平行随机对照试验。
医疗健身设施处。
17例择期CABG手术术前患者被随机分为标准护理组（n = 9）和Prehab组（n = 8）。
标准护理：三小时的术前评估预约。Prehab：每天进行60分钟的运动和教育课程，每周两次，至少持续四周。
在基线、术前一周和术后三个月收集数据。主要结局指标是使用6分钟步行试验的步行距离。次要结局变量包括5米步态速度以及术后三个月的心脏康复参与率。
15例患者（标准护理组，n = 7；Prehab组，n = 8）完成了研究。在研究参与期间，没有Prehab组患者出现心脏症状。标准护理组的步行距离保持不变；而Prehab组在术前和术后三个月评估时，步行距离增加到平均±标准差474±101米和487±106米（p < 0.05）。标准护理组的步态速度没有变化，但Prehab组在术前和术后三个月分别提高了27%和33%（p < 0.05）。术后三个月，Prehab参与者的心脏康复参与率（100%）高于标准护理参与者（43%；p < 0.05）。
这些数据为Prehab干预改善等待择期CABG手术患者健康状况的可行性提供了证据。将利用一项纳入92例患者的更大规模试验来证明Prehab的安全性和有效性。
