IMR Press / RCM / Volume 24 / Issue 5 / DOI: 10.31083/j.rcm2405141
Open Access Systematic Review
Efficacy of Multiple Exercise Therapy after Coronary Artery Bypass Graft: A Systematic Review of Randomized Control Trials
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1 Rehabilitation Center, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
2 Department of Cardiac Surgery, Qilu Hospital of Shandong University, 250012 Jinan, Shandong, China
3 Department of Cardiovascular and Thoracic Surgery, National Heart Hospital, 10101 Lusaka, Zambia
*Correspondence: yonghuiwangphd@163.com (Yong-Hui Wang)
These authors contributed equally.
Rev. Cardiovasc. Med. 2023, 24(5), 141; https://doi.org/10.31083/j.rcm2405141
Submitted: 19 November 2022 | Revised: 26 January 2023 | Accepted: 3 February 2023 | Published: 9 May 2023
(This article belongs to the Section Cardiovascular Quality and Outcomes)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Coronary artery bypass graft (CABG) is intended to restore myocardial perfusion and alleviate morbidity among patients suffering from coronary artery disease. Due to procedural complexity, and anesthetic medications, post-operative complications are more prevalent, requiring the integration of rehabilitation strategies. This review aimed to determine the effect of single and multiple exercise therapy on rehabilitation after CABG surgery. Methods: We conducted a systematic search of databases (EBSCOhost, Scopus, PubMed, and Web of Science) from 01 January 2000 to 15 September 2022. The protocol of this systematic review is registered to PROSPERO. Results: We found nine randomized control trials composed of 599 CABG patients. In-patient cardiac rehabilitation (CR), a combination of inspiratory muscle training, mobilization, active upper and lower limb exercise, and aerobic exercise as multiple exercise therapy, found significant improvement in 6-minute walking distance (6MWD) than single exercise therapy (breathing exercise) at discharge and follow-up (moderate quality evidence). Contrary, multiple exercises group compared to single exercise groups did not improve the peak volume of oxygen (VO2) at discharge. Still, significant improvement was found at follow-up (moderate quality of evidence). On the other hand, the out-patient CR made up of high-intensity inspiratory muscle training, upper and lower limbs resistance training, and aerobic exercise as multiple exercise therapy significantly improved 6MWD and peak VO2 at discharge (High-quality evidence). Conclusions: Our review revealed that multiple exercise therapy significantly improves functional and exercise capacity in in-patient and out-patient cardiac rehabilitation settings than single exercise therapy, but more than double exercise therapy protocol may be inefficient for improvement of quality of life. Inspiratory muscle training and resistance training in exercise therapy protocols significantly supplant the outcome, which requires further investigation.

Keywords
cardiac rehabilitation
coronary artery disease
CABG
exercise therapy
post-operative care
Funding
81972154/National Natural Science Foundation of China
82172536/National Natural Science Foundation of China
Figures
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