Effects a Rehabilitation Program in Patients With Left Ventricular Dysfunction After Coronary Artery Bypass Grafting

Federal University of São Paulo

Status: Unknown

Conditions: Disorder; Heart, Functional, Postoperative, Cardiac Surgery

Treatments: Other: Neuromuscular electrical stimulation; Other: Stationary cycling exercise; Other: Walking exercise

Study type: Interventional

Funder types: Other

Identifiers

NCT02763774

31295914.0.0000.5505

Details and patient eligibility

About

This study aims to analyze effects of three types of cardiac rehabilitation protocol on fuctional capacity, inflammatory markers, pulmonary function and clinical outcomes after coronary artery bypass grafting (CABG) in patients with left ventricular disfunction. Patients will be randomized and allocated in three groups according to type of exercise protocol: 1. walk; 2. cycle; 3. functional electrical stimulation.

Full description

Several studies have been demonstrated beneficial effects of exercise to minimize impact of CABG. However, there is no consensus on what kind of exercise is safe and effective for patients with left ventricular dysfunction.

Walking

Enrollment: 45 estimated patients

Sex: All

Ages: 35 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Coronary artery disease proven by coronary angiography;
• Elective CABG;
• No acute or chronic pulmonary disease;
• Patients after surgery, keep in spontaneous ventilation on first postoperative day;
• Absence of neurological, neuromuscular, musculoskeletal and osteoarticular incapacitating;
• Consent form signed for participation in the survey.

Exclusion criteria

• Inability to perform spirometry;
• Presence of acute lung disease or chronic;
• Surgical indication of urgency;
• Morbid obesity;
• Hemodynamics instability at the time of spirometry or during six minutes walking test;
• Intraoperative death or until the sixth postoperative day;
• Patients remaining in mechanical prolonged ventilation for more than 12 hours;
• Severe cardiac arrhythmia during application of assessment protocols and exercises (ventricular tachycardia, atrioventricular block second or degree) any other condition the investigator's discretion put the patient at increased risk with beginning of the year; Any change that may lead to failure of proposed protocols.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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45 participants in 3 patient groups

Walking exercise

Experimental group

Description:

Participants will be sumitted to progressive exercises and supervised by a physiotherapist, active-assisted to free active exercise in upper and lower limbs, stationary running and walking. The intensity of walk will be determined by the Borg's sujective effort perception scale - (modified from zero to 10). On first postoperative day, participants will perform exercises in supine position. From the second to the fifth postoperative day, they will perform progressive walking.

Treatment:

Other: Walking exercise

Stationary cycling exercise

Experimental group

Description:

Participants will be sumitted to progressive exercises and supervised by a physiotherapist, active-assisted to free active exercise in upper and lower limbs. From the first to the fifth postoperative day, they will perform progressive cycling exercise.The intensity of cycling will be determined by the Borg's sujective effort perception scale - (modified from zero to 10).

Treatment:

Other: Stationary cycling exercise

Neuromuscular electrical stimulation

Experimental group

Description:

Participants will be sumitted to progressive exercises and supervised by a physiotherapist, active-assisted to free active exercise in upper and lower limbs. From the first to the fifth postoperative day, quadriceps and gastrocnemius muscles will be percutaneous stimulated with the following parameters: Synchronic mode, 50Hz, 400uS, time on 10s, time off 20s, intensity as tolerated by the patient.

Treatment:

Other: Neuromuscular electrical stimulation