Can resistance prehabilitation training bring additional benefits in valvular cardiac surgery? protocol for a
Jorge Montero-Cámara1, Francisco José Ferrer-Sargues1, María José Segrera Rovira1,2
1Deparment of Nursing and Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Alfara del Patriarca, Valencia, Spain.
Insights
Adding resistance training (RT) to prehabilitation programs for cardiac surgery patients may reduce intensive care unit (ICU) and hospital length of stay (LOS). This approach aims to improve recovery and quality of life for individuals with cardiovascular diseases.
Area of Science:
- Cardiology
- Rehabilitation Medicine
- Exercise Physiology
Background:
- Cardiovascular diseases (CVD) often necessitate major surgery.
- Fast-track rehabilitation programs aim to decrease postoperative complications and hospital stay.
- Prehabilitation, including exercise, is crucial for patient recovery.
Purpose of the Study:
- To evaluate the impact of adding resistance training (RT) to standard prehabilitation for cardiac surgery patients.
- To determine if this combined approach reduces intensive care unit (ICU) length of stay (LOS).
- To assess reductions in postoperative complications and overall hospital LOS.
Main Methods:
- Prospective, parallel, randomized clinical trial with 96 adult patients undergoing surgery for valvular pathology.
- Participants randomly assigned to a control group (respiratory and aerobic exercise) or an experimental group (additional RT of peripheral muscles).
- Primary outcomes: ICU and hospital LOS. Secondary outcomes: exercise capacity, quality of life, and respiratory values.
Main Results:
- This study is the first controlled clinical trial investigating the addition of strength exercise to prehabilitation.
- Anticipated results will demonstrate the efficacy of RT in improving patient outcomes.
- Focus on maintaining pulmonary training alongside peripheral exercises.
Conclusions:
- The inclusion of RT in prehabilitation protocols shows promise for enhancing recovery after cardiac surgery.
- Improved physical condition can lead to increased patient participation and quality of life.
- Findings will inform the development of optimized rehabilitation and prehabilitation strategies for CVD patients.
Introduction:
Cardiovascular diseases (CVD) are a group of illnesses that include coronary heart disease, cerebrovascular disease, congenital heart disease and deep vein thrombosis. Major surgery is often chosen as the treatment of choice for CVD. The concept of fast-track rehabilitation after surgery appeared in the 1970s. Participation in these exercise-based prehabilitation programmes may decrease postoperative complications and length of hospital stay. The primary aim of the present study is to evaluate whether the implementation of an additional resistance training (RT) prehabilitation protocol within cardiac exercises based prehabilitation can reduce intensive care unit (ICU) length of stay, postoperative complications and hospital length of stay (LOS).
Methods:
A protocol of a prospective, parallel, randomised clinical trial includes 96 adult patients diagnosed with valvular pathology and who have been scheduled for surgery. The participants will be randomly assigned to two groups of 48. Control group will be treated with ventilatory and strengthening of respiratory muscles, and aerobic exercise. Experimental group, in addition, will be treated with RT of peripheral muscles. Both hospital stay and ICU stay will be assessed as main variables. Other secondary variables such as exercise capacity, quality of life and respiratory values will also be assessed. Quantitative variables will be analysed with a T-Test or ANOVA, or Mann Witney if the distribution is non-parametric.
Results And Conclusion:
This will be the first controlled clinical study focused on adding strength exercise as an additional treatment during prehabilitation. The results of this study will focus on helping to improve rehabilitation and prehabilitation protocols, considering that it is essential to maintain pulmonary training, as well as the inclusion of peripheral exercises that help people with heart disease to be in a better physical condition in order to increase their participation and sense of quality of life.
Related Concept Videos
01:22Heart Failure VI: Adjunct Therapies
01:29Cardiomyopathy V: Interprofessional Care
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management