Phase III cardiac rehabilitation after CABG: Combined aerobic and strengthening exercise protocols

Abstract

Aims Little is known of the short-term effects of combined aerobic and strengthening exercises—as components of phase III cardiac rehabilitation— in patients of Middle Eastern origin who have undergone coronary artery bypass grafting (CABG). This study aimed to assess the efficacy of exercise protocols used during phase III cardiac rehabilitation of patients from Iran who had undergone this procedure. Methods The study compared the effect of combined aerobic and strengthening exercises vs aerobics alone on the functional capacity, muscle strength, serum lipids and blood pressure of 88 patients, 4-5 weeks after CABG. A control group performed aerobics while three experimental groups performed combined aerobic and strengthening exercises, 5 days a week over 5 weeks. The functional capacity, muscle strength and serum lipids were determined at baseline and specific time points during the study. Heart rate and blood pressure were measured before and after each session. Findings The combined exercise protocols improved the functional capacity and muscle strength to a significantly greater extent than the aerobic protocol. Serum total cholesterol, low-density lipoproteins and triglyceride levels decreased insignificantly, however, the high-density lipoproteins level increased significantly in all groups. Systolic blood pressure declined insignificantly but the diastolic blood pressure remained unchanged in all groups. Conclusions The results suggest that the combined exercises were superior to the aerobics alone for positive changes in patients’ functional capacity and muscle strength, with effects lasting up to follow-up.

The effect of progressive resistance training on aerobic fitness and strength in adults with coronary heart disease: A systematic review and meta-analysis of randomised controlled trials

“…Only seven studies (21%) were considered to be of high quality (≥6/10). 47,48,51–55 Common limitations were lack of allocation concealment, subject, therapist and assessor blinding, intention-to-treat analysis, and reporting of key outcome measures for more than 85% of randomised subjects. It is acknowledged that blinding of therapists and subjects is not possible in these study designs, thus potentially limiting the achievable maximal score to eight rather than 10.…”

“…This included four studies with multiple comparison groups [46][47][48][49] and three studies examining different PRT dose prescriptions during CT interventions. [50][51][52] The characteristics of included studies are presented in Supplementary Material, Table 1.…”

“…Only seven studies (21%) were considered to be of high quality (!6/10). 47,48,[51][52][53][54][55] Common limitations were lack of allocation concealment, subject, therapist and assessor blinding, intention-to-treat Hollings et al…”

The Effect of Aquatic and Dryland Resistance Training on Peroxisome Proliferator Activated Receptor-ɑ Gene Expression in Middle-aged Women’s Peripheral Blood Mononuclear Cell after Coronary Artery Bypass Grafting

“…The control group in this study did only aerobic exercises while the other three performed a combination of aerobic and resistance training. Due to the combined therapeutic training in that study, there was an improvement in muscle strength in addition to the statistically significant changes in the blood serum HDL levels (38). (39).…”

“…Studies investigating CABG patients have mostly focused on the role of physical activity in improving the quality of life through the evaluation of physical performance and muscle strength, social functioning, mental health, as well as body composition and lipid profile in these patients (15,16,37). Moghadam et al (2009) studied the effect of aerobic and resistance training on functional capacity factors, serum lipid profile, blood pressure and muscle strength during cardiac rehabilitation. The control group in this study did only aerobic exercises while the other three performed a combination of aerobic and resistance training.…”