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 signi?cantly more in IG compared to CG. Similar effects were observed postoperatively in FC (6MWD(IG): Delta-64.7 m, p(T1-T3 =) 0.013; Delta+47.2 m, p(T1-T4 <) 0.001; TUG(IG): Delta+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.