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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Exercise-based cardiac rehabilitation for postcoronary artery bypass grafting and its effect on hemodynamic responses
Ahmad Osailan1, Walid Kamal Abdelbasset1
1Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 16278, Saudi Arabia.
Insights
Supervised exercise training improved heart function in coronary artery bypass grafting patients. This cardiac rehabilitation program enhanced hemodynamic responses and exercise capacity, highlighting its importance for recovery.
Area of Science:
- Cardiology
- Exercise Physiology
- Rehabilitation Medicine
Background:
- Coronary artery bypass grafting (CABG) is a common surgery to restore blood flow to blocked arteries.
- Cardiac rehabilitation is used post-CABG, but studies on exercise training's effects on hemodynamic responses using the Incremental Shuttle Walking Test (ISWT) are limited in Saudi Arabia.
Purpose of the Study:
- To assess the impact of hospital-based, exercise-based cardiac rehabilitation (Phase 3) on hemodynamic responses in post-CABG patients.
- Specifically investigated were blood pressure, heart rate (HR), heart rate recovery (HRR), and rate pressure product (RPP) using the ISWT.
Main Methods:
- Fifteen CABG patients underwent 8 weeks of supervised, moderate-intensity exercise training (aerobic and resistance).
- Hemodynamic parameters were measured using the ISWT before (ISWT1) and after (ISWT2) the rehabilitation program.
- Measurements included resting and post-ISWT blood pressure, HR, HRR, and rate pressure product (RPP).
Main Results:
- Significant reductions in resting systolic (SBP) and diastolic (DBP) blood pressure were observed.
- Significant increases in post-ISWT SBP, peak HR, HRR, and maximum RPP were noted after training.
- Patients also showed significant improvements in speed and distance achieved during the ISWT.
Conclusions:
- Eight weeks of supervised exercise training effectively improved hemodynamic responses and functional exercise capacity in CABG patients.
- Increased implementation of cardiac rehabilitation is recommended for post-CABG patients.
- Further regional research is needed to validate these findings.
Background:
Coronary artery bypass grafting (CABG) is a common surgical procedure for the restoration of blood flow into stenotic or blocked coronary arteries. Cardiac rehabilitation has been implemented to some extent worldwide for the management of postoperative CABG. However, studies about the effect of exercise training on hemodynamic responses of the heart using the Incremental Shuttle Walking (ISWT) test are limited in Saudi Arabia.
Objectives:
To investigate the effect of exercise-based cardiac rehabilitation (Phase 3, hospital-based) on some hemodynamic responses including blood pressure, heart rate (HR) and heart rate recovery (HRR), and rate pressure product (RPP) using ISWT on post-CABG patients.
Methods:
Fifteen CABG (51.4 ± 6.4 years, 14 male, 1 female) patients without altering their medication were enrolled in a hospital-based cardiac rehabilitation program (Phase 3) between 2011 and 2012 for supervised individual exercise training sessions (three times per week for 8 weeks; 60-minute session at a moderate intensity). Patients performed two tests (ISWT1 and ISWT2) and one before exercise training program and one after, during which resting systolic blood pressure (SBP) and diastolic blood pressure (DBP), post-ISWT SBP and DBP, resting HR, peak HR, HRR (which was defined as the absolute change from peak HR to 1-minute post peak HR), and RPP at rest and at the end of the ISWT were measured. Exercise training sessions included both aerobic and resistance exercises, which were preceded by a cooling down period and followed by a recovery period.
Results:
Paired t-test showed a significant reduction in both resting SBP (p = 0.04) and DBP (p = 0.03), and a significant increase in post-ISWT2 SBP (p = 0.004), peak HR (p = 0.003), HRR (p = 0.03), and RPP at maximum (p = 0.002) after 8 weeks of supervised exercise training. In addition, there was a significant increase in the speed and distance achieved on ISWT2 (p < 0.001) after the training program.
Conclusion:
Supervised exercise training (cardiac rehabilitation) for 8 weeks was effective in improving hemodynamic responses and functional exercise capacity in CABG patients. Cardiac rehabilitation should be implemented more frequently and health-care providers should be aware of its importance. Further research is needed in this area to confirm these findings in the region.
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