Is early, low level, short term exercise cardiac rehabilitation following coronary bypass surgery beneficial? A randomised controlled trial. (Scientific Letter).

Heart 2002;88:83-84

Through the relief of myocardial ischaemia, the goal of coronary artery bypass grafting (CABG) is to preserve and if possible to restore cardiac function towards normality. Evaluation of cardiovascular haemodynamics has enhanced our understanding of functional disability in cardiac patients, and provided prognostic classification. (1) It is therefore important to investigate whether exercise rehabilitation following CABG is able to confer further improvements in cardiac performance as well as increasing functional capacity. Exercise rehabilitation has been reported to improve the prognosis, (2) exercise capacity, and cardiac performance of patients with coronary artery disease. The levels of cardiac rehabilitation service provision within the UK are very varied. (3) We have therefore investigated whether a representative hospital based supervised cardiac rehabilitation programme providing early, low level, and short term exercise training can improve the cardiac and physical functional status of patients post -CABG.

METHODS

We interviewed 100 patients who were on the waiting list for CABG and found that only 22 of them expressed no preference either for or against exercise rehabilitation following their surgery. They performed a familiarising cardiopulmonary exercise test. Six weeks postoperatively the patients were randomised either to attend the hospital based exercise rehabilitation programme or supervise their own recovery. Those in the rehabilitation group attended once a week for six weeks. On each occasion they completed 12 aerobic exercise stations specifically designed to incorporate the use of different skeletal muscle groups. Each week the level of exercise was increased to incorporate more repetitions or a greater workload. The patients …