The Efficacy of Inpatient vs. Home-Based Physiotherapy Following Coronary Artery Bypass Grafting

Aleksandra Szylińska, Mariusz Listewnik, Iwona Rotter, Aleksandra Rył, Katarzyna Kotfis, Krzysztof Mokrzycki, Ewelina Kuligowska, Paweł Walerowicz and Mirosław Brykczyński
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Aleksandra Szylińska: Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, ul. Żołnierska 54, 70-204 Szczecin, Poland
Mariusz Listewnik: Department of Cardiac Surgery, Pomeranian Medical University in Szczecin, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland
Iwona Rotter: Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, ul. Żołnierska 54, 70-204 Szczecin, Poland
Aleksandra Rył: Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, ul. Żołnierska 54, 70-204 Szczecin, Poland
Katarzyna Kotfis: Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland
Krzysztof Mokrzycki: Department of Cardiac Surgery, Pomeranian Medical University in Szczecin, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland
Ewelina Kuligowska: Department of Cardiac Surgery, Pomeranian Medical University in Szczecin, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland
Paweł Walerowicz: Department of Cardiac Surgery, Pomeranian Medical University in Szczecin, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland
Mirosław Brykczyński: Department of Cardiac Surgery, Pomeranian Medical University in Szczecin, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland

IJERPH, 2018, vol. 15, issue 11, 1-11

Abstract: Background : Intensive post-operative physiotherapy after cardiac surgery helps to reduce the number of complications, accelerating convalescence and decreasing peri-operative mortality. Cardiac rehabilitation is aimed at regaining lost function and sustaining the effect of cardiac surgery. The aim of this study was to compare the efficacy of inpatient and home-based phase II physiotherapy following coronary artery bypass grafting, and inpatient phase II post-operative physiotherapy based on the analysis of the spirometry results. Methods : A prospective observational study included 104 adult patients of both sexes undergoing planned coronary artery bypass grafting and were randomized to one of the two groups—inpatients (InPhysio) and home-based (HomePhysio) at a 1:1 ratio. All patients had undergone spirometry testing prior to surgery (S1) and on the fifth day after the operation (S2), i.e., on the day of completion of the first phase (PI) of physiotherapy. Both the study group (InPhysio) and the control group (HomePhysio) performed the same set of exercises in the second phase (PII) of cardiac physiotherapy, either in the hospital or at home, respectively, according to the program obtained in the hospital. Both groups have undergone spirometry testing (S3) at 30 days after the operation. Results : The demographic and peri-operative data for both groups were comparable and showed no statistically significant differences. An analysis of gradients between the results of spirometry tests before surgery and at 30 days after the surgery showed a smaller decrease in forced vital capacity (FVC) in the study group than in the control group ( p < 0.001). The results at five and 30 days after the surgery showed a greater increase in FVC in the study group than in the control group (680 mL vs. 450 mL, p = 0.009). There were no statistically significant differences in other parameters studied. Conclusions : The advantage of inpatient over home-based physiotherapy was evidenced by much smaller decreases in FVC between the initial and final tests, and greater increases between the fifth day after surgery and the final test. Our analysis showed greater efficacy of inpatient physiotherapy as compared with home-based exercises and raises concerns about patient adherence.

Keywords: cardiac rehabilitation; forced expiratory volume in 1 s; forced vital capacity; coronary artery bypass grafting (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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