Prehabilitation in patients awaiting elective coronary artery bypass graft surgery – effects on functional capacity and quality of life: a randomized controlled trial.

Steinmetz C; Bjarnason-Wehrens B; Baumgarten H; Walther T; Mengden T; Walther C;

Clinical rehabilitation [Clin Rehabil] 2020 Jun 16, pp. 269215520933950. Date of Electronic Publication: 2020 Jun 16.

Objective: To determine the impact of an exercise-based prehabilitation (EBPrehab) program on pre- and postoperative exercise capacity, functional capacity (FC) and quality of life (QoL) in patients awaiting elective coronary artery bypass graft surgery (CABG).
Design: A two-group randomized controlled trail.
Setting: Ambulatory prehabilitation.
Subjects: Overall 230 preoperative elective CABG-surgery patients were randomly assigned to an intervention (IG, n  = 88; n  = 27 withdrew after randomization) or control group (CG, n  = 115).
Intervention: IG: two-week EBPrehab including supervised aerobic exercise. CG: usual care.
Main Measures: At baseline (T1), one day before surgery (T2), at the beginning (T3) and at the end of cardiac rehabilitation (T4) the following measurements were performed: cardiopulmonary exercise test, six-minute walk test (6MWT), Timed-Up-and-Go Test (TUG) and QoL (MacNew questionnaire).
Results: A total of 171 patients (IG, n  = 81; CG, n  = 90) completed the study. During EBPrehab no complications occurred. Preoperatively FC (6MWT IG : 443.0 ± 80.1 m to 493.5 ± 75.5 m, P  = 0.003; TUG IG : 6.9 ± 2.0 s to 6.1 ± 1.8 s, P  = 0.018) and QoL (IG: 5.1 ± 0.9 to 5.4 ± 0.9, P  < 0.001) improved significantly more in IG compared to CG. Similar effects were observed postoperatively in FC (6MWD IG : Δ-64.7 m, p T1-T3 =  0.013; Δ+47.2 m, p T1-T4 <  0.001; TUG IG : Δ+1.4 s, p T1-T3 =  0.003).
Conclusions: A short-term EBPrehab is effective to improve perioperative FC and preoperative QoL in patients with stable coronary artery disease awaiting CABG-surgery.