Exercise performances of frail patients undergoing cardiac surgery at a preoperative exercise training program: a preliminary result
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摘要Introduction 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.
出版社接受日期18.08.2019
著者King Wai Derek YAU, Man Kin Henry WONG, Malcolm John UNDERWOOD, Gavin Matthew JOYNT, Anna LEE
會議名稱Evidence-Based Perioperative Medicine (Asia) 2019 Congress
會議開始日01.11.2019
會議完結日03.11.2019
會議地點Singapore
會議國家/地區新加坡
出版年份2019
語言英式英語
關鍵詞Cardiac surgery, Preoperative rehabilitation

上次更新時間 2020-01-06 於 14:21