Exercise performances of frail patients undergoing cardiac surgery at a preoperative exercise training program: a preliminary result
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AbstractIntroduction and Aim: Preoperative frailty is associated with poorer clinical outcomes and higher healthcare costs in patients undergoing cardiac surgery. Prehabilitation before surgery could offer an opportunity to enhance physical fitness, and hence improve frailty and postoperative recovery. The objective of this preliminary report was to investigate the exercise performance of pre-frail and frail adults awaiting coronary artery bypass grafting with or without valve surgery during a preoperative exercise training program (PET).
Method: This is an ongoing single-centre, superiority, stratified randomised controlled trial (ChiCTR1800016098). Preliminary results of the initial eight patients randomised to the exercise training group (1-hour sessions, twice weekly between July 2018 to June 2019) were analysed using generalized estimating equations. Exercise performance was evaluated by examining mean change in exercise intensity by percentage change of baseline predicted peak oxygen consumption reserve (VO2Rbaseline) with individuals’ responses monitored by percentage of age-predicted maximum heart rate (HRmax) during training.
Results: The median (IQR) age was 65 (59-67) years and two patients (25%) were female. One participant was frail [Clinical Frailty Scale (CFS) 5] while seven participants were pre-frail (CFS 4). The median (IQR) number of exercise sessions performed before surgery and attendance rates were 12 (7-30) and 98.7% (86.5%-100%) respectively. Patients tolerated individually prescribed exercise well. By the eighth session, the mean exercise intensity was above 80% of VO2Rbaseline [mean (95% CI): 102.8% (91.0%-114.6%)] [Figure 1]. The mean (95% CI) progression in exercise intensity reached up to 108% (104%-112%) of their VO2Rbaseline while the mean (95% CI) percentage of HRmax was 66% (65%-67%) during training. There were no adverse events reported during PET.
Conclusions: The physiotherapist-supervised PET was well tolerated by pre-frail and frail patients waiting for cardiac surgery, with good progression of exercise intensity achieved. PET might improve the functional and physical fitness of the patients waiting for elective cardiac surgery.
Acceptance Date18/08/2019
All Author(s) ListKing Wai Derek YAU, Man Kin Henry WONG, Malcolm John UNDERWOOD, Gavin Matthew JOYNT, Anna LEE
Name of ConferenceEvidence-Based Perioperative Medicine (Asia) 2019 Congress
Start Date of Conference01/11/2019
End Date of Conference03/11/2019
Place of ConferenceSingapore
Country/Region of ConferenceSingapore
LanguagesEnglish-United Kingdom
KeywordsCardiac surgery, Preoperative rehabilitation

Last updated on 2020-01-06 at 14:21