IJCRR - Vol 05 Issue 15 , August, 2013
EFFECT OF CARDIAC REHABILITATION VS HOME EXERCISES AFTER CORONARY ARTERY BYPASS GRAFTING (CABG) ON HEMODYNAMICS
Author: Pratibha Manhas, Tushar J. Palekar
Background: Exercise training has been shown to modify the sympathovagal control of heart rate toward an increase in parasympathetic tone. At the same time, the improved vagal activity is associated with reduced death risk from cardiac events (Wu S-K, Lin Y-W et al). Although a cardiac rehabilitation exercise program is standard therapy for patients after a cardiac event and especially for those who have received Coronary artery bypass grafting (CABG), the relationship between a cardiac rehabilitation exercise programme and acute hemodynamics and comparison with home based exercise programme has not been clearly demonstrated. Objectives: To find the effect of cardiac rehabilitation and home exercises on blood pressure, Heart rate, Respiratory Rate and Rating of perceived exertion (RPE) and compare the effects of cardiac rehabilitation and home exercises. Method: Thirty consecutive eligible patients undergone Coronary artery bypass grafting (CABG) referred by cardiovascular surgeons had participated in this study. After completion of baseline exercise stress test at discharge or within first week after discharge were randomly assigned to group A (Hospital based Cardiac rehabilitation) and group B (Home based cardiac rehabilitation) for 6 weeks. Materials: Perceived exertion scale, Stop watch, Blood Pressure apparatus, Pulse oxymeter Result: There were significant improvements in hemodynamics (p=0.000) both with hospital based cardiac rehabilitation and home based exercises but there were no significant differences between hospital cardiac rehabilitation and home based exercises. Conclusion: This study had concluded that both hospital based cardiac rehabilitation and home based exercises are effective in improving acute hemodynamics.
Keywords: CABG, Cardiac Rehabilitation, Home Exercises
Pratibha Manhas, Tushar J. Palekar. EFFECT OF CARDIAC REHABILITATION VS HOME EXERCISES AFTER CORONARY ARTERY BYPASS GRAFTING (CABG) ON HEMODYNAMICS International Journal of Current Research and Review. Vol 05 Issue 15 , August, 95-101
1. Thompson D, Bowman G, Kitson A, de Bono D, Hopkins A: Cardiac rehabilitation services in England and Wales: a national survey. Int J Cardiol 1997, 59:299-304.
2. Campbell N, Grimshaw J, Rawles J and Ritchie L: Cardiac rehabilitation in Scotland: is current provision satisfactory? J Public Health Med 1996, 18:478-480.
3. Taylor RS, Brown A, Ebrahim S, et al. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med 2004;116(10):682– 692.
4. Benzer W. Oldridge NB: Current concepts in cardiac rehabilitation medical considerations and outcomes evaluations. J Clin Basic Cardiol 2001;4:211-19
5. Katte Jolly, Rod S. et al: Home based cardiac rehabilitation compared with centre based rehabilitation and usual care: A systematic review and metanalysis. International Journal of Cardiology111(2006);343-351
6. Lucini D, Richard VM, Costantino G, Lavie C, Porta A, Pagani M: Effects of cardiac rehabilitation and exercise training on autonomic regulation in patients with coronary artery disease. Am Heart J 2002;143:977-83
7. Thornton EW, Fabri BM, Fox MA, Jackson M: Predicting blood pressure reactivity and heart rate variability from mood state following coronary artery bypass surgery. Int J Psychophysiol 2003; 47:43-55
8. Hedback B, Perk J, Engvall J, Areskog N: Cardiac rehabilitation after coronary artery bypass grafting: effects on exercise performance and risk factors. Arch Phys Med Rehabil 1990,71:1069-1073.
9. Ben-Ari E, Kellerman J, Fisman E, Pines A, Peled B and Drory Y: Benefits of long-term physical training in patients after coronary artery bypass grafting – a 58 month follow-up and comparison with a maintained group. J Cardiopulm Rehabil 1986,6:165-170.
10. Engblom E, Korpilahti K, Hamalainen H, Ronnemaa T and Puukka P: Quality of Life and Return to Work 5 Years After Coronary Artery Bypass Surgery long term results of cardiac rehabilitation. J Cardiopulm Rehabil 1997, 17:29-36.
11. Nishime EO, Cole CR, Wallace GS,et al: Heart rate recovery improved in a cohort of adults after cardiac rehabilitation. J Am Coll Cardiol 2002;39:164
12. Tiukinhoy S, Beohar N, Hsie M: Improvement in heart rate recovery after cardiac rehabilitation. J Cardiopulm Rehabil 2003;23:84-87
13. Kligfield P, McCormick A, Chai A,Jacobson A,Feuerstadt P, Hao SC: Effect of age and gender on heart rate recovery after submaximal exercise during cardiac rehabilitation in patients with angina pectoris, recent acute myocardial infarction or coronary bypass surgery. Am J Cardiol 2003;92:600- 603
14. Lind L,Andren B: Heart rate recovery after exercise is related to the insulin resistance syndrome and heart rate variability in elder men. Am Heart J 2002;144:666-72
15. Gordon NF, English CD, Contractor AS, et al: Effectiveness of three models for comprehensive cardiovascular disease risk reduction. Am J Cardiol 2002;89:1263-68
16. Wu S-K, Lin Y-W, Chen C-L, Tsai SW:Cardiac Rehabilitation vs Home Exercise after coronary artery bypass graft surgery: A comparison of heart rate recovery. Am J Phys Med Rehabil 2006;85:711-717.
17. Weber UK, Pfisterer M et al: Low dose sotalol to prevent supraventricular arrhythimas after CABG surgery and its effect on hospital stay. J Am Coll cardiol 1996;27:309-10.
18. Kavanagh T , Mertens DJ et al : Peak oxygen intake and cardiac mortality in women reffered for cardiac rehabilitation. J Am Coll Cardiol 2003;42:2139-43.
19. Pardo Y, Merz CN et al: Exercise conditioning and heart rate variability: evidence of a threshold effect. Clin Cardiol 2000; 23: 615- 20.
20. Smith KM, Arthur HM et al: Differences in sustainability of exercise and health related quality of life outcomes following home or hospital based cardiac rehabilitation. Eur J Cardiovasc Prev Rehabil 2004:11:313-19.