Disorder; Heart, Functional, Postoperative, Cardiac Surgery
Conditions
Keywords
coronary artery bypass, sistemic inflammatory response syndrome, left ventricular dysfunction, postoperative complications, physical fitness
Brief summary
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.
Detailed 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
Interventions
OTHERWalking exercise
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.
OTHERStationary cycling exercise
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).
OTHERNeuromuscular electrical stimulation
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.
Sponsors
Federal University of São Paulo
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
35 Years to 75 Years
Healthy volunteers
No
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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Functional Capacity | Up to ten days after surgery, at hospital discharge. | Participants will be submitted to six minute walk test on preoperative period and sixth postoperative day (or before hospital discharge) to evaluate functional capacity. The test will be performed with a mobile device to measure metabolic response to exercise (Oxycon™ Mobile). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Inflammatory markers | in-hospital postoperative period, up to ten days after surgery. | Blood sample will be collected to measure inflammatory markers (TNF-alpha and interleukins) and to compare exercise effects on inflammatory response after surgery. |
Countries
Brazil
Contacts
Primary ContactSolange Guizilini, PhD
Outcome results
None listed