Supervised moderate intensity exercise improves distance walked at hospital discharge following coronary artery bypass graft surgery - A randomised controlled trial

Background: This study aimed to determine whether a structured, inpatient (or Phase 1 cardiac rehabilitation), physiotherapy-supervised walking program, with or without musculoskeletal and respiratory exercises, might improve walking capacity and other parameters for patients undergoing coronary artery bypass graft surgery (CABG). Methods: Ninety-three patients awaiting first-time CABG over a 12-month period were randomised to one of three post-operative physiotherapy regimens: 'standard intervention', consisting of gentle mobilisation; 'walking exercise', consisting of a physiotherapy-supervised, moderate intensity walking program; and 'walking/breathing exercise', consisting of the same moderate intensity walking program, musculoskeletal exercises and respiratory exercises. Primary outcomes; six-minute walking assessment (6MWA) distance, vital capacity and health-related quality of life, were measured pre-operatively, at discharge from hospital and at four weeks following discharge. Results: Walking and walking/breathing exercise groups had significantly higher 6MWA distance (444 +/- 84 m, 431 98 in, respectively) than the standard intervention group (377 90 m) at discharge from hospital. There was no significant difference between intervention groups for 6MWA distance at four-week follow-up. There was no significant difference between intervention groups in terms of vital capacity and health-related quality of life. Conclusions: A physiotherapy-supervised, moderate intensity walking program in the inpatient phase following CABG improves walking capacity at discharge from hospital. The performance of respiratory and musculoskeletal exercises confers no additional benefit to the measured outcomes.