Department of Cardiothoracic Surgery/Department of Nursing, Faculty of Health and Technology, Rigshospitalet, University of Copenhagen/ Metropolitan University College, , 2100 Copenhagen , Denmark.
J Rehabil Med. 2019 Feb 1;51(2):136-143. doi: 10.2340/16501977-2499.
Rehabilitation of patients following coronary artery bypass grafting (CABG) has been widely studied; however, research into early rehabilitation after CABG is sparse. The aim of this trial was to assess the impact of early rehabilitation, compared with usual care in patients following CABG.
Randomized controlled trial.
A total of 326 patients treated with CABG.
Patients treated with CABG were randomized 1:1 to 4 weeks of comprehensive early rehabilitation or usual care. The primary outcome was the Six Minute Walk Test (6MWT). Secondary outcomes were mental health and physical activity (Medical Outcome Study Short Form; SF-12); anxiety and depression (Hospital Anxiety and Depression Scale; HADS); physical and emotional scores; sleep (Pittsburgh Sleep Quality Index; PSQI); pain (Örebro Musculoskeletal Screening Questionnaire; ÖMSQ) and muscle endurance (Sit-To-Stand test).
Sixteen patients dropped out. No significant differences between groups in the primary outcome (6MWT) were found after 4 weeks (p = 0.27). For secondary outcomes the odds ratio of HADS-D ≥ 8 decreased in favour of the experimental intervention (p = 0.04). There was non-adherence to parts of the intervention. Per-protocol analysis showed differences between groups for the 6MWT (p = 0.02) and the Sit-To-Stand test (p = 0.046).
In general, the intervention had no effect on the 6MWT, or secondary outcomes, except for depressive symptoms. However, in adherent participants, the intervention had a positive effect for the primary and several secondary outcomes.
对冠状动脉旁路移植术（CABG）后的患者进行康复治疗已有广泛研究；然而，CABG 后早期康复的研究却很少。本试验旨在评估与 CABG 后常规护理相比，早期康复对患者的影响。
随机对照试验。
共 326 例接受 CABG 治疗的患者。
将接受 CABG 治疗的患者以 1:1 的比例随机分为 4 周综合早期康复组或常规护理组。主要结局指标为 6 分钟步行试验（6MWT）。次要结局指标为心理健康和身体活动（医疗结局研究简表；SF-12）；焦虑和抑郁（医院焦虑和抑郁量表；HADS）；身体和情绪评分；睡眠（匹兹堡睡眠质量指数；PSQI）；疼痛（奥勒松肌肉骨骼筛查问卷；ÖMSQ）和肌肉耐力（坐站测试）。
16 例患者退出。4 周后，两组在主要结局（6MWT）上无显著差异（p=0.27）。对于次要结局，HADS-D≥8 的比值比有利于实验干预（p=0.04）。干预措施的部分内容没有得到遵守。意向性治疗分析显示，6MWT（p=0.02）和坐站测试（p=0.046）两组间存在差异。
一般来说，该干预措施对 6MWT 或次要结局均无影响，除了抑郁症状。然而，在依从性好的参与者中，该干预措施对主要和一些次要结局有积极影响。
