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The Efficacy of Inpatient vs. Home-Based Physiotherapy Following Coronary Artery Bypass Grafting

Background: Intensive post-operative physiotherapy after cardiac surgery helps to reduce the number of complications, accelerating convalescence and decreasing peri-operative mortality. Cardiac rehabilitation is aimed at regaining lost function and sustaining the effect of cardiac surgery. The aim o...

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Autores principales: Szylińska, Aleksandra, Listewnik, Mariusz, Rotter, Iwona, Rył, Aleksandra, Kotfis, Katarzyna, Mokrzycki, Krzysztof, Kuligowska, Ewelina, Walerowicz, Paweł, Brykczyński, Mirosław
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6266912/
https://www.ncbi.nlm.nih.gov/pubmed/30453599
http://dx.doi.org/10.3390/ijerph15112572
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author Szylińska, Aleksandra
Listewnik, Mariusz
Rotter, Iwona
Rył, Aleksandra
Kotfis, Katarzyna
Mokrzycki, Krzysztof
Kuligowska, Ewelina
Walerowicz, Paweł
Brykczyński, Mirosław
author_facet Szylińska, Aleksandra
Listewnik, Mariusz
Rotter, Iwona
Rył, Aleksandra
Kotfis, Katarzyna
Mokrzycki, Krzysztof
Kuligowska, Ewelina
Walerowicz, Paweł
Brykczyński, Mirosław
author_sort Szylińska, Aleksandra
collection PubMed
description Background: Intensive post-operative physiotherapy after cardiac surgery helps to reduce the number of complications, accelerating convalescence and decreasing peri-operative mortality. Cardiac rehabilitation is aimed at regaining lost function and sustaining the effect of cardiac surgery. The aim of this study was to compare the efficacy of inpatient and home-based phase II physiotherapy following coronary artery bypass grafting, and inpatient phase II post-operative physiotherapy based on the analysis of the spirometry results. Methods: A prospective observational study included 104 adult patients of both sexes undergoing planned coronary artery bypass grafting and were randomized to one of the two groups—inpatients (InPhysio) and home-based (HomePhysio) at a 1:1 ratio. All patients had undergone spirometry testing prior to surgery (S1) and on the fifth day after the operation (S2), i.e., on the day of completion of the first phase (PI) of physiotherapy. Both the study group (InPhysio) and the control group (HomePhysio) performed the same set of exercises in the second phase (PII) of cardiac physiotherapy, either in the hospital or at home, respectively, according to the program obtained in the hospital. Both groups have undergone spirometry testing (S3) at 30 days after the operation. Results: The demographic and peri-operative data for both groups were comparable and showed no statistically significant differences. An analysis of gradients between the results of spirometry tests before surgery and at 30 days after the surgery showed a smaller decrease in forced vital capacity (FVC) in the study group than in the control group (p < 0.001). The results at five and 30 days after the surgery showed a greater increase in FVC in the study group than in the control group (680 mL vs. 450 mL, p = 0.009). There were no statistically significant differences in other parameters studied. Conclusions: The advantage of inpatient over home-based physiotherapy was evidenced by much smaller decreases in FVC between the initial and final tests, and greater increases between the fifth day after surgery and the final test. Our analysis showed greater efficacy of inpatient physiotherapy as compared with home-based exercises and raises concerns about patient adherence.
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spelling pubmed-62669122018-12-15 The Efficacy of Inpatient vs. Home-Based Physiotherapy Following Coronary Artery Bypass Grafting Szylińska, Aleksandra Listewnik, Mariusz Rotter, Iwona Rył, Aleksandra Kotfis, Katarzyna Mokrzycki, Krzysztof Kuligowska, Ewelina Walerowicz, Paweł Brykczyński, Mirosław Int J Environ Res Public Health Article Background: Intensive post-operative physiotherapy after cardiac surgery helps to reduce the number of complications, accelerating convalescence and decreasing peri-operative mortality. Cardiac rehabilitation is aimed at regaining lost function and sustaining the effect of cardiac surgery. The aim of this study was to compare the efficacy of inpatient and home-based phase II physiotherapy following coronary artery bypass grafting, and inpatient phase II post-operative physiotherapy based on the analysis of the spirometry results. Methods: A prospective observational study included 104 adult patients of both sexes undergoing planned coronary artery bypass grafting and were randomized to one of the two groups—inpatients (InPhysio) and home-based (HomePhysio) at a 1:1 ratio. All patients had undergone spirometry testing prior to surgery (S1) and on the fifth day after the operation (S2), i.e., on the day of completion of the first phase (PI) of physiotherapy. Both the study group (InPhysio) and the control group (HomePhysio) performed the same set of exercises in the second phase (PII) of cardiac physiotherapy, either in the hospital or at home, respectively, according to the program obtained in the hospital. Both groups have undergone spirometry testing (S3) at 30 days after the operation. Results: The demographic and peri-operative data for both groups were comparable and showed no statistically significant differences. An analysis of gradients between the results of spirometry tests before surgery and at 30 days after the surgery showed a smaller decrease in forced vital capacity (FVC) in the study group than in the control group (p < 0.001). The results at five and 30 days after the surgery showed a greater increase in FVC in the study group than in the control group (680 mL vs. 450 mL, p = 0.009). There were no statistically significant differences in other parameters studied. Conclusions: The advantage of inpatient over home-based physiotherapy was evidenced by much smaller decreases in FVC between the initial and final tests, and greater increases between the fifth day after surgery and the final test. Our analysis showed greater efficacy of inpatient physiotherapy as compared with home-based exercises and raises concerns about patient adherence. MDPI 2018-11-17 2018-11 /pmc/articles/PMC6266912/ /pubmed/30453599 http://dx.doi.org/10.3390/ijerph15112572 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Szylińska, Aleksandra
Listewnik, Mariusz
Rotter, Iwona
Rył, Aleksandra
Kotfis, Katarzyna
Mokrzycki, Krzysztof
Kuligowska, Ewelina
Walerowicz, Paweł
Brykczyński, Mirosław
The Efficacy of Inpatient vs. Home-Based Physiotherapy Following Coronary Artery Bypass Grafting
title The Efficacy of Inpatient vs. Home-Based Physiotherapy Following Coronary Artery Bypass Grafting
title_full The Efficacy of Inpatient vs. Home-Based Physiotherapy Following Coronary Artery Bypass Grafting
title_fullStr The Efficacy of Inpatient vs. Home-Based Physiotherapy Following Coronary Artery Bypass Grafting
title_full_unstemmed The Efficacy of Inpatient vs. Home-Based Physiotherapy Following Coronary Artery Bypass Grafting
title_short The Efficacy of Inpatient vs. Home-Based Physiotherapy Following Coronary Artery Bypass Grafting
title_sort efficacy of inpatient vs. home-based physiotherapy following coronary artery bypass grafting
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6266912/
https://www.ncbi.nlm.nih.gov/pubmed/30453599
http://dx.doi.org/10.3390/ijerph15112572
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