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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Efficacy of Multiple Exercise Therapy after Coronary Artery Bypass Graft: A Systematic Review of Randomized Control
Md Moneruzzaman1, Wei-Zhen Sun1, Geoffrey J Changwe2,3
1Rehabilitation Center, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China.
Insights
Multiple exercise therapy significantly enhances rehabilitation after coronary artery bypass graft (CABG) surgery, improving functional capacity. However, overly complex protocols may not improve quality of life, warranting further research into optimal exercise strategies.
Area of Science:
- Cardiology
- Rehabilitation Medicine
- Exercise Physiology
Background:
- Coronary artery bypass graft (CABG) surgery aims to restore heart function but carries risks of post-operative complications.
- Effective rehabilitation strategies are crucial for patients undergoing CABG.
- This review examines the impact of single versus multiple exercise therapy on post-CABG recovery.
Purpose of the Study:
- To systematically review the effects of single and multiple exercise therapy interventions on patient rehabilitation following CABG surgery.
- To compare the efficacy of different exercise modalities in improving functional capacity and exercise tolerance post-CABG.
Main Methods:
- Systematic literature search of databases including PubMed, Scopus, Web of Science, and EBSCOhost from 2000 to 2022.
- Inclusion of nine randomized controlled trials involving 599 CABG patients.
- Analysis of outcomes related to functional capacity (e.g., 6-minute walking distance) and exercise tolerance (e.g., peak oxygen uptake).
Main Results:
- Multiple exercise therapy, including inspiratory muscle training and aerobic exercise, showed significant improvements in 6-minute walking distance in inpatient settings compared to single exercise therapy.
- Peak oxygen uptake improvements were observed at follow-up in the multiple exercise group but not at discharge.
- Outpatient cardiac rehabilitation incorporating high-intensity inspiratory muscle training, resistance training, and aerobic exercise significantly improved both 6-minute walking distance and peak oxygen uptake at discharge.
Conclusions:
- Multiple exercise therapy demonstrates superior efficacy over single exercise therapy in enhancing functional and exercise capacity for both inpatient and outpatient cardiac rehabilitation after CABG.
- Protocols involving extensive exercise combinations may not necessarily lead to improved quality of life.
- Inspiratory muscle training and resistance training are key components that significantly influence outcomes, meriting further investigation.
Background:
Coronary artery bypass graft (CABG) is intended to restore myocardial perfusion and alleviate morbidity among patients suffering from coronary artery disease. Due to procedural complexity, and anesthetic medications, post-operative complications are more prevalent, requiring the integration of rehabilitation strategies. This review aimed to determine the effect of single and multiple exercise therapy on rehabilitation after CABG surgery.
Methods:
We conducted a systematic search of databases (EBSCOhost, Scopus, PubMed, and Web of Science) from 01 January 2000 to 15 September 2022. The protocol of this systematic review is registered to PROSPERO.
Results:
We found nine randomized control trials composed of 599 CABG patients. In-patient cardiac rehabilitation (CR), a combination of inspiratory muscle training, mobilization, active upper and lower limb exercise, and aerobic exercise as multiple exercise therapy, found significant improvement in 6-minute walking distance (6MWD) than single exercise therapy (breathing exercise) at discharge and follow-up (moderate quality evidence). Contrary, multiple exercises group compared to single exercise groups did not improve the peak volume of oxygen ( ) at discharge. Still, significant improvement was found at follow-up (moderate quality of evidence). On the other hand, the out-patient CR made up of high-intensity inspiratory muscle training, upper and lower limbs resistance training, and aerobic exercise as multiple exercise therapy significantly improved 6MWD and peak at discharge (High-quality evidence).
Conclusions:
Our review revealed that multiple exercise therapy significantly improves functional and exercise capacity in in-patient and out-patient cardiac rehabilitation settings than single exercise therapy, but more than double exercise therapy protocol may be inefficient for improvement of quality of life. Inspiratory muscle training and resistance training in exercise therapy protocols significantly supplant the outcome, which requires further investigation.
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