Pre-habilitation in elderly patients undergoing cardiac surgery

Complete

01/11/2018

Surgery

North East

Exercise & Lifestyle

Awarded amount: £147,572

Grant scheme: TRP

Institution: South Tees Hospitals NHS Foundation Trust

Principle Investigator: Prof Enoch Akowuah

---

Prehabilitation refers to programmes of prescribed exercise given to patients ahead of surgery, with the aim of improving their physical fitness and function to ultimately facilitate recovery after surgery.

This project was designed to evaluate the efficacy of a prehabilitation programme for people undergoing elective cardiac surgery. The protocol focused on whether prehabilitation could improve physical muscle function as well as frailty and quality of life prior to surgery, alongside informing the development of a multi centre clinical trial.

This was a resulting study from the James Lind Alliance Heart Surgery Priority Setting Partnership, for which Heart Research UK funded the original focus groups. Despite delays due to COVID, the original recruitment target of 180 patients was fulfilled. However, there was no statistically significant improvement in fitness levels for those who received prehabillitation versus the control group.

There was some indication that quality deep breathing and frailty may be improved but these results were not significant. There was some additional evidence to suggest that the prehabilitation programme did improve attitudes and confidence towards physical activity, which persisted after surgery. Whilst the results from the trial were not of great significance, the outcomes did provide insight into how to effectively and safely deliver a trial of this nature. This will contribute to the development of guidelines for future practice.

A number of publications have resulted from the trial, and the team are currently in the process of applying for further, larger scale funding, in order to further develop and refine the cardiac rehabilitation programme.