Prehabilitation in patients awaiting elective coronary artery bypass graft surgery – effects on functional capacity and quality of life: a randomized controlled trial

OBJECTIVE: To determine the impact of an exercise-based prehabilitation (EBPrehab) program on pre- and postoperative exercise capacity, functional capacity (FC) and quality of life (QoL) in patients awaiting elective coronary artery bypass graft surgery (CABG). DESIGN: A two-group randomized controlled trail. SETTING: Ambulatory prehabilitation. SUBJECTS: Overall 230 preoperative elective CABG-surgery patients were randomly assigned to an intervention (IG, n = 88; n = 27 withdrew after randomization) or control group (CG, n = 115). INTERVENTION: IG: two-week EBPrehab including supervised aerobic exercise. CG: usual care. MAIN MEASURES: At baseline (T1), one day before surgery (T2), at the beginning (T3) and at the end of cardiac rehabilitation (T4) the following measurements were performed: cardiopulmonary exercise test, six-minute walk test (6MWT), Timed-Up-and-Go Test (TUG) and QoL (MacNew questionnaire). RESULTS: A total of 171 patients (IG, n = 81; CG, n = 90) completed the study. During EBPrehab no complications occurred. Preoperatively FC (6MWT(IG): 443.0 ± 80.1 m to 493.5 ± 75.5 m, P = 0.003; TUG(IG): 6.9 ± 2.0 s to 6.1 ± 1.8 s, P = 0.018) and QoL (IG: 5.1 ± 0.9 to 5.4 ± 0.9, P < 0.001) improved significantly more in IG compared to CG. Similar effects were observed postoperatively in FC (6MWD(IG): Δ-64.7 m, p(T1–T3 = )0.013; Δ+47.2 m, p(T1–T4 < )0.001; TUG(IG): Δ+1.4 s, p(T1–T3 = )0.003). CONCLUSIONS: A short-term EBPrehab is effective to improve perioperative FC and preoperative QoL in patients with stable coronary artery disease awaiting CABG-surgery. ID: NCT04111744 (www.ClinicalTrials.gov; Preoperative Exercise Training for Patients Undergoing Coronary Artery Bypass Graft Surgery- A Prospective Randomized Trial)