COMPARATIVE ANALYSIS OF EFFICIENCY OF SUPERVISED AND HOME-BASED PHYSICAL TRAININGS IN THE OUTPATIENT CARDIAC REHABILITATION PROGRAM IN PATIENTS AFTER CORONARY ARTERY BYPASS GRAFTING

Abstract

The purpose. To assess the impact of the three-month supervised and home-based physical trainings in the outpatient cardiac rehabilitation program on exercise tolerance and double product in patients undergoing coronary artery bypass grafting (CABG). Material and methods: 114 male patients of working age with coronary artery disease (CAD) who have undergone CABG were examined. Patients were enrolled into three groups: Group 1 − patients undergoing supervised cycling trainings (SCT) (n = 36), Group 2 − patients undergoing home-based trainings (HBT) (n = 36) and the control group without any exercise trainings (n = 42). The following parameters were assessed: the six-minute walk test (6MWT) value, exercise tolerance (ET) and double product (DP), determined by the cycle ergometer test (CET) prior to surgery, 1, 4 months and 1 year after CABG. Results: The 6MWT value increased by 9% in the SCT group, by 6% in the HBT group, and by 1% in the control group during the outpatient cardiac rehabilitation program. ET significantly increased in all study groups according to the analysis of exercise tolerance by the CET 4 months after CABG. However, the improvement was more pronounced in patients with SCT compared to other groups. One year after CABG, this difference balanced between the study groups. DP, assessed by the CET, significantly increased in patients undergoing SCT (p = 0.01), compared to other groups. There were no significant differences found in the rate of cardiovascular events between the study groups. Conclusion: Home-based trainings are inferior to SCT in the outpatient settings, but they are safe and may improve significantly the 6MWT values compared to patients in the control group. Therefore, home-based trainings may be recommended to patients, if they cannot visit the rehabilitation center.