Intensification of in-hospital rehabilitation in elective post-coronary artery bypass grafting patients: both safe and effective

Introduction:
New standards for cardiac rehabilitation are currently being established worldwide.

Aim:
To evaluate the effectiveness of in-hospital rehabilitation models in patients after coronary artery bypass grafting (CABG).

Material and methods:
One hundred men with stable coronary artery disease were randomly assigned to two groups: standard model (SM) and intense model (IM). Subjects then underwent CABG and were rehabilitated according to the assigned model. Effects were verified by the 6-minute walk test (6MWT), which was performed before and after the intervention.

Results:
In the initial 6MWT, subjects in the SM group achieved a higher SpO₂ (Me: SM = 97%, 98%; IM = 96%, 97%). In the final 6MWT, subjects in the IM group achieved a higher SpO₂ (Me: SM = 96%, 97%; IM = 97%, 98%), a lower initial HR (Me: SM = 84; IM = 78) and a lower post-exercise HR (Me: SM = 92.5; IM = 84.5), a longer distance covered (Me: SM = 312 m; IM = 359 m), a lower fatigue (Me: SM = 3; IM = 1) and a shorter hospitalization time. Group differences between initial and final 6MWT; In IM: SBP and SpO₂ in the initial 6MWT were higher than in the final 6MWT, HR in the initial 6MWT was lower than in the final 6MWT, distance travelled in the initial 6MWT was longer than in the final 6MWT, reported fatigue in the initial 6MWT was lower than in the final 6MWT. In IM: SBP in the initial 6MWT was higher than in the final 6MWT, SpO₂ and HR in the initial 6MWT were lower than in the final 6MWT.

Conclusions:
The intense model showed a more favorable effect on the physical and functional status. Increasing the load, extending the duration of training sessions, and expanding the range of functionality are safe.