Jacqueline Pengelly1, Colin Royse2, Gavin Williams3, Adam Bryant3, Sandy Clarke-Errey4, Alistair Royse5, Doa El-Ansary6. 1. Department of Nursing and Allied Health, Swinburne University of Technology, Melbourne, Vic, Australia; School of Science, Psychology and Sport, Federation University Australia, Ballarat, Vic, Australia. Electronic address: jpengelly@swin.edu.au. 2. Department of Nursing and Allied Health, Swinburne University of Technology, Melbourne, Vic, Australia; Department of Surgery, University of Melbourne, Melbourne, Vic, Australia; Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Vic, Australia; Outcomes Research Consortium Cleveland Clinic, Cleveland, OH, USA. 3. Department of Physiotherapy, University of Melbourne, Melbourne, Vic, Australia. 4. Statistical Consulting Centre, University of Melbourne, Melbourne, Vic, Australia. 5. Department of Nursing and Allied Health, Swinburne University of Technology, Melbourne, Vic, Australia; Department of Surgery, University of Melbourne, Melbourne, Vic, Australia; Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Melbourne, Vic, Australia. 6. Department of Nursing and Allied Health, Swinburne University of Technology, Melbourne, Vic, Australia; Department of Surgery, University of Melbourne, Melbourne, Vic, Australia; Clinical Research Institute, Westmead Private Hospital, Sydney, NSW, Australia.
Abstract
AIMS: To investigate the effects of a 12-week early moderate-intensity resistance training program compared to aerobic-based rehabilitation on postoperative cognitive recovery following cardiac surgery via median sternotomy. METHODS: This was a multicentre, prospective, pragmatic, non-blinded, pilot randomised controlled trial (1:1 randomisation) of two parallel groups that compared a 12-week early moderate-intensity resistance training group to a control group, receiving aerobic-based rehabilitation. English-speaking adults (≥18 years) undergoing elective cardiac surgery via median sternotomy were randomised using sealed envelopes, with allocation revealed before surgery. The primary outcome was cognitive function, assessed using the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog), at baseline, 14 weeks and 6 months postoperatively. RESULTS: The ADAS-cog score at 14 weeks was significantly better for the resistance training group (n=14, 7.2±1.4; 95% CI 4.3, 10.2, vs n=17, 9.2±1.3; 95% CI 6.6, 11.9, p=0.010). At 14 weeks postoperatively, 53% of the aerobic-based rehabilitation group (n=9/17) experienced cognitive decline by two points or more from baseline ADAS-cog score, compared to 0% of the resistance training group (n=0/14; p=0.001). CONCLUSION: Early resistance training appears to be safe and may improve cognitive recovery compared to standard, aerobic-based rehabilitation following cardiac surgery via median sternotomy, however as this was a pilot study, the sample size was small and further research is needed to determine a causal relationship.
AIMS: To investigate the effects of a 12-week early moderate-intensity resistance training program compared to aerobic-based rehabilitation on postoperative cognitive recovery following cardiac surgery via median sternotomy. METHODS: This was a multicentre, prospective, pragmatic, non-blinded, pilot randomised controlled trial (1:1 randomisation) of two parallel groups that compared a 12-week early moderate-intensity resistance training group to a control group, receiving aerobic-based rehabilitation. English-speaking adults (≥18 years) undergoing elective cardiac surgery via median sternotomy were randomised using sealed envelopes, with allocation revealed before surgery. The primary outcome was cognitive function, assessed using the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog), at baseline, 14 weeks and 6 months postoperatively. RESULTS: The ADAS-cog score at 14 weeks was significantly better for the resistance training group (n=14, 7.2±1.4; 95% CI 4.3, 10.2, vs n=17, 9.2±1.3; 95% CI 6.6, 11.9, p=0.010). At 14 weeks postoperatively, 53% of the aerobic-based rehabilitation group (n=9/17) experienced cognitive decline by two points or more from baseline ADAS-cog score, compared to 0% of the resistance training group (n=0/14; p=0.001). CONCLUSION: Early resistance training appears to be safe and may improve cognitive recovery compared to standard, aerobic-based rehabilitation following cardiac surgery via median sternotomy, however as this was a pilot study, the sample size was small and further research is needed to determine a causal relationship.
Authors: Jacqueline Pengelly; Stuart Boggett; Adam Bryant; Colin Royse; Alistair Royse; Gavin Williams; Doa El-Ansary Journal: Phys Ther Date: 2022-07-04