The Effectiveness of Early Rehabilitation after Cardiac Surgery

iDepartment of Cardiovascular Surgery, Hyogo Brain and Heart Center, Himeji, Japanj

Tasuku Honda Nobuhiko Mukohara Masato Yoshida
Keitaro Nakagiri Tsutomu Shida
The purpose of this study was to evaluate the efficacy of early rehabilitation starting on the day after cardiac surgery. In the early rehabilitation program, introduced from November 2006, we adopted an original video program about hospitalization and daily multi-specialist conference in the ICU. We divided 179 patients who underwent elective cardiac operation from June 2004 to September 2007imean age 65.4 years old, 51 women, 91 CABG, 53 valve procedures and 35 other procedurejinto group Aithe initial rehabilitation group:n73jand group Bithe early rehabilitation group:n106). There were no significant differences in patient profileiage, gender, operation time etc.jbetween the two groups. The mean postoperative day of starting cardiac rehabilitation was 4.3{/|1.6 days in group A and 1.5{/|1.0 days in group Bip0.01). The mean achievement period of all walking distances in group B was significantly shorter than in group A as follows, 50m:group A 5.4{/|2.2 vs. group B 3.1{/|1.5 daysip0.01), 100m:group A 6.9{/|3.1 vs. group B 4.9{/|2.2 daysip0.01), 200m:group A 8.5{/|3.9 vs. group B 6.5{/|2.5 daysip0.01), 300m:group A 10.2{/|3.9 vs. group B 8.1{/|2.9 daysip0.01), 500m:group A 14.5{/|6.1 vs. group B 11.9{/|3.8 daysip0.05). Approximately 90 per cent of patients in group B could walk by themselves on leaving the ICU. There were no major complications throughout rehabilitation. The mean hospital stay was 31.0{/|11.2 days for group A and 25.9{/|7.4 days for the group B, with a statistically significant differenceip0.03). In a questionnaire survey at discharge, 91.0 per cent of patients in group B answered that early rehabilitation was most gratifying. In conclusion, early rehabilitation after cardiac surgery is effective for early recovery of ADL and leads to shorter hospital stay. We think both preoperative education and daily conferences are indispensable for safe and effective early rehabilitation programs.
  Jpn. J. Cardiovasc. Surg. 38:314-318i2009j