Article

OBJECTIVE: To compare models of the postoperative hospital treatment phase after
myocardial revascularization. Design: A pilot randomized controlled trial.
Setting: Hospital patients in a hospital setting. SUBJECTS: Thirty-two patients
with indications for myocardial revascularization were included between January
2008 and December 2009, with
a left ventricular ejection fraction (LVEF) >/=50%,
1-second forced expiratory volume (FEV(1)) >/=60 and forced vital capacity (FVC)
>/=60% of predicted value. INTERVENTIONS: Patients were randomly placed into two
groups: one performed prescribed exercises according to the model proposed by the
American College of Sports Medicine (ACSM) and the other according to a
periodized model. Main measures: Partial pressure of O(2) (P o (2)) and arterial
O(2) saturation (Sao (2)), percentage of predicted FVC
and total distance on the
six-minute walking test (6MWT). RESULTS: Twenty-seven patients were re-evaluated
upon release from the hospital (ACSM = 14 and PP = 13).
Five patients extubated
for more than 6 hours in the postoperative period were excluded from the sample.
In the preoperative period the variables P o (2), Sao (2), % FVC and 6MWT were
similar. In the postoperative period, a reduction was observed for all parameters
in both groups. Upon comparison of the groups, a difference was observed in P o
(2) (ACSM = 68.0 +/- 4.3 vs.
PP = 75.9 +/- 4.8 mmHg; P < 0.001), Sao (2) (ACSM =
93.5 +/- 1.4 vs. PP = 94.8 +/- 1.2%; P = 0.018) and 6MWT (ACSM = 339.3 +/- 41.7
vs. PP = 393.8 +/- 25.7 m; P < 0.001). There was no difference in % FVC.
CONCLUSION: Patients after myocardial revascularization following a periodized
model of exercise presented a better intra-hospital evolution when compared to
those using the ACSM model.

Langue : ANGLAIS