The effects of exercise-based prehabilitation in patients undergoing coronary artery bypass grafting surgery: A systematic review of randomized controlled trials

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Heart & Lung Pub Date : 2024-09-21 DOI:10.1016/j.hrtlng.2024.09.007

Hidaye Yamikan, Gamze Nur Ahiskali, Aynur Demirel, Ebru Calik Kütükcü

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Abstract

Background

Postoperative exercise-based rehabilitation improves the physical performance and health-related outcomes of patients undergoing coronary artery bypass grafting (CABG). However, the effectiveness of exercise-based prehabilitation in patients undergoing CABG remains unknown.

Objective

The purpose of this systematic review was to investigate the effects of exercise-based prehabilitation on functional exercise capacity, postoperative complications, anxiety, depression, self-efficacy, quality of life, length of hospital and intensive care unit stay, frailty, and endothelial function in patients undergoing CABG surgery.

Methods

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The study protocol is recorded in the PROSPERO database (registration number CRD42023488530). PubMed, the Physiotherapy Evidence Database (PEDro), Google Scholar, Web of Science, Scopus, and the Cochrane Library were searched from inception to December 2023. The titles and abstracts of the studies were screened using Rayyan Ai software. After full-text screening, randomized controlled trials that met the inclusion criteria were included.

Results

Five randomized controlled trials involving 616 participants were included. The systematic review suggests strong evidence that exercise-based prehabilitation improved functional capacity and moderate evidence that it reduced postoperative complications and length of hospital stay. Although there was conflicting evidence regarding the effects of exercise-based prehabilitation on quality of life, there was limited evidence of its effects on physical activity, anxiety, depression, self-efficacy, frailty, and endothelial function.

Conclusions

Exercise-based prehabilitation can be recommended for improvements in functional capacity, postoperative complications, and length of hospital stay in patients undergoing CABG.

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以运动为基础的术前康复训练对冠状动脉旁路移植手术患者的影响：随机对照试验的系统回顾。

背景：术后运动康复可改善冠状动脉旁路移植术（CABG）患者的体能表现和健康相关结果。然而，在接受冠状动脉旁路移植术的患者中，以运动为基础的术前康复的有效性仍不为人所知：本系统性综述旨在研究运动前康复对接受冠状动脉旁路移植手术患者的功能锻炼能力、术后并发症、焦虑、抑郁、自我效能、生活质量、住院时间和重症监护室住院时间、虚弱程度和内皮功能的影响：本系统综述遵循系统综述和元分析首选报告项目 (PRISMA) 指南。研究方案记录在 PROSPERO 数据库中（注册号 CRD42023488530）。对 PubMed、物理治疗证据数据库 (PEDro)、Google Scholar、Web of Science、Scopus 和 Cochrane 图书馆进行了从开始到 2023 年 12 月的检索。使用 Rayyan Ai 软件对研究的标题和摘要进行筛选。全文筛选后，纳入了符合纳入标准的随机对照试验：结果：共纳入了 5 项随机对照试验，涉及 616 名参与者。系统综述显示，有确凿证据表明以运动为基础的术前康复可提高患者的功能能力，也有中等程度的证据表明运动可减少术后并发症和住院时间。虽然关于运动康复对生活质量的影响存在相互矛盾的证据，但有有限的证据表明运动康复对身体活动、焦虑、抑郁、自我效能、虚弱和内皮功能有影响：结论：建议进行以运动为基础的术前康复，以改善接受 CABG 患者的功能能力、术后并发症和住院时间。

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来源期刊

Heart & Lung 医学-呼吸系统

CiteScore

4.60

自引率

3.60%

发文量

184

审稿时长

35 days

期刊介绍： Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders. The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.