Article

Coronary artery bypass grafting (CABG) is accompanied by severe
impairment of cardiac autonomous regulation (CAR). This study aimed to determine
whether a short-term physiotherapy exercise protocol post-CABG, during inpatient
cardiac rehabilitation (CR), might improve CAR.
DESIGN: Seventy-four patients
eligible for CABG were recruited and randomised into physiotherapy exercise group
(EG) or physiotherapy usual care group (UCG). EG patients underwent a short-term
supervised inpatient physiotherapy exercise protocol consisting of an early
mobilisation with progressive exercises plus usual care (respiratory exercises).
UCG only received respiratory exercises. Forty-seven patients (24 EG and 23 UGC)
completed the study. Outcome measures of CAR included linear and non-linear
measures of heart rate variability (HRV) assessed before discharge. RESULTS: By
hospital discharge, EG presented significantly higher parasympathetic HRV values
[rMSSD, high frequency (HF), SD1)], global power (STD RR, SD2), non-linear HRV
indexes [detrended fluctuation analysis (DFA)alpha1, DFAalpha2, approximate
entropy (ApEn)] and mean RR compared to UCG (p<0.05). Conversely, higher values
of mean HR, low frequency (LF) (sympathetic activity) and the LF/HF (global
sympatho-vagal balance) were found in the UCG. CONCLUSIONS: A short-term
supervised physiotherapy exercise protocol during inpatient CR improves CAR at
the time of discharge. Thus, exercise-based inpatient CR might be an effective
non-pharmacological tool to improve autonomic cardiac tone in patient's
post-CABG.

Langue : ANGLAIS