Early Aerobic Exercise after Coronary Artery Bypass Surgery: A Systematic Review

Abstract

Introduction: Aerobic exercise (AE) reduces morbidity and mortality for patients following coronary artery bypass graft (CABG) surgery. AE is commonly commenced at least 4 weeks following CABG during outpatient cardiac rehabilitation. AE in the early postoperative period may improve aerobic and functional capacity of patients at hospital discharge. The aim of the present study was to assess the outcomes of early AE following CABG. Methods: A systematic review of the literature was conducted for studies published on outcomes of patients undergoing early (commencing within 2 weeks of CABG) aerobic or functional exercise training. Predefined inclusion criteria included studies reporting on early (<4 weeks) outcomes. Results: Seven studies were identified according to selection criteria. A total of 473 patients received early AE interventions. Functional capacity when measured by 6-minute walk test (6MWT) was higher in early AE groups (mean = 404.6m) compared with control groups (mean = 378m). Mean ventilatory anaerobic threshold following early AE was 12.15 ml/kg/min and mean peak oxygen uptake was 18.2 ml/kg/min. Early postoperative outcomes included atrial fibrillation (22.9%), deep sternal wound infection (0%) and mortality (0%). Discussion: This study is the only review of early exercise following CABG identified from the current literature. Our results indicate that early AE can be safely performed in selected patients following uncomplicated CABG, with improvements in functional and aerobic capacity in the early postoperative period. Future studies should focus on patient cohorts at higher risk of acute functional or aerobic deconditioning such as the elderly, obese and those with functional limitations from comorbidities.