Physiological and Health-Related Quality of Life Outcomes Following Cardiac Rehabilitation after Cardiac Surgery

Abstract

Abstract. We investigated the changes of an 8-week cardiac rehabilitation (CR) program on physiological outcomes and health-related quality of life (HRQL) in Japanese cardiac surgery patients. Subjects were 47 consecutive outpatients (32 men, 15 women; mean age 59.4 ± 12.6 years) recovering from cardiac surgery. Patients performed both aerobic exercise on a treadmill at anaerobic threshold intensity and moderate resistance training 2 days per week, 60 min per session, from 1 to 3 months after cardiac surgery. Differences in the eight SF-36 subscale scores and physiological outcomes within the patient group at 1 month and at 3 months after cardiac surgery were analyzed. Peak oxygen uptake, handgrip strength, and knee extension strength were used as physiological outcome measures. HRQL was assessed with the Japanese version Medical Outcome Study Short Form 36 (SF-36). Significant change in overall physiological outcome from 1 month to 3 months was observed. There was also significant change in seven of the eight SF-36 health status subscale scores (physical functioning, role-physical, bodily pain, general health, vitality, role-emotional, and mental health). However, with the exception of physical functioning and mental health scores, values did not reach those of the average healthy Japanese. In conclusion, we found that CR exercise training for Japanese cardiac surgery patients during the recovery phase changes not only physiological outcomes but also HRQL as assessed by the SF-36.

Changes in Health Utility of Patients after Cardiac Surgery

“…Another study also indicated that improvement of psychological outcomes following phase II CR was similar to that of HRQOL in patients undergoing coronary artery bypass grafting and valve replacement [5]. There were significant increases in average SF-6D utility scores from 1 to 3 months in both groups (Table 2).…”

“…Physiological outcomes were also previously reported after cardiac surgery in patients undergoing coronary artery bypass grafting and valve replacement [5][6][7][8]. The reported goals of cardiac rehabilitation (CR) for these patients are to improve exercise capacity, reduce coronary risk factors, improve health-related quality of life (HRQOL), and reduce subsequent cardiac events, sudden death, all-cause mortality, and hospitalization costs [5][6][7][8][9]. However, with regard to the economic evaluation of hospital costs, several previous studies suggested that health utility, which can be assessed by several preference-based utility measures, is an important measure in the analysis of cost effectiveness in health care [10][11][12][13].…”

“…Physiological outcomes were also previously reported after cardiac surgery in patients undergoing coronary artery bypass grafting and valve replacement [5][6][7][8]. The reported goals of cardiac rehabilitation (CR) for these patients are to improve exercise capacity, reduce coronary risk factors, improve health-related quality of life (HRQOL), and reduce subsequent cardiac events, sudden death, all-cause mortality, and hospitalization costs [5][6][7][8][9].…”

“…Following discharge from the hospital, the patients entered the recovery phase II CR outpatient program at 1 month after cardiac surgery, and they continued in the program for 2 months, until 3 months after surgery [4,5]. The patients participated in supervised combined aerobic and resistance exercise training once or twice a week for 1 hour.…”

“…Each session was composed of a warm-up, aerobic exercise, resistance training, and cool down period. Exercise intensity during aerobic exercise was maintained at anaerobic threshold heart-rate level using treadmill walking or cycle ergometer with a rating of perceived exertion of [11][12][13] (according to the Borg 6-20 scale) [4,5,8].…”