Exercise Parameters and Outcome Measures Used in Cardiac Rehabilitation Programs Following Median Sternotomy in the Elderly: A Systematic Review and Meta-Analysis

Jacqueline Pengelly, Michael Pengelly, Kuan-Yin Lin, Colin Royse, Roshan Karri, Alistair Royse, Adam Bryant, Gavin Williams, Doa El-Ansary

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Objective: The aim of this systematic review was to identify exercise parameters and outcome measures used in cardiac rehabilitation programs following median sternotomy, in the elderly cardiac population. Data Sources: Five (5) electronic databases were searched for relevant studies published in English after 1997. Study Selection: The screening process was completed by two independent researchers, with a third independent reviewer for overall agreement. Studies were selected if they included only cardiac patients aged ≥65 years who had undergone valve surgery and/or coronary artery bypass grafting via median sternotomy, and who had undertaken a postoperative cardiac rehabilitation exercise intervention assessing physical function and/or cognitive recovery as outcomes. Data Extraction: Two researchers independently completed the data extraction and quality assessment. Quality was assessed using a modified Downs and Black tool. Data Synthesis: In total, 11 articles were included for appraisal with respect to the quality of the study. Only two randomised controlled trials were suitable for meta-analysis. A higher volume of exercise was shown to have a positive effect on functional recovery, assessed using the 6-minute walk test (6MWT) (mean difference = 26.97 m; 95% confidence interval [CI], 6.96–46.97; p = 0.008; I2 = 0%). No significant improvement was shown between additional exercise compared to standard care in improving VO2peak, maximal power output or quality of life. No studies evaluated the effect of exercise on cognitive recovery. Conclusions: Exercise significantly improves functional recovery in the post-surgical elderly cardiac population, however uncertainty still exists with regard to which modes of exercise and their specific parameters are most effective in improving cognitive recovery.

Original languageEnglish
Pages (from-to)1560-1570
Number of pages11
JournalHeart Lung and Circulation
Volume28
Issue number10
DOIs
Publication statusPublished - 2019 Oct 1

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Sternotomy
Meta-Analysis
Outcome Assessment (Health Care)
Exercise
Research Personnel
Exercise Therapy
Information Storage and Retrieval
Coronary Artery Bypass
Cognition
Population
Uncertainty
Cardiac Rehabilitation
Randomized Controlled Trials
Quality of Life
Databases
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Pengelly, Jacqueline ; Pengelly, Michael ; Lin, Kuan-Yin ; Royse, Colin ; Karri, Roshan ; Royse, Alistair ; Bryant, Adam ; Williams, Gavin ; El-Ansary, Doa. / Exercise Parameters and Outcome Measures Used in Cardiac Rehabilitation Programs Following Median Sternotomy in the Elderly : A Systematic Review and Meta-Analysis. In: Heart Lung and Circulation. 2019 ; Vol. 28, No. 10. pp. 1560-1570.
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Exercise Parameters and Outcome Measures Used in Cardiac Rehabilitation Programs Following Median Sternotomy in the Elderly : A Systematic Review and Meta-Analysis. / Pengelly, Jacqueline; Pengelly, Michael; Lin, Kuan-Yin; Royse, Colin; Karri, Roshan; Royse, Alistair; Bryant, Adam; Williams, Gavin; El-Ansary, Doa.

In: Heart Lung and Circulation, Vol. 28, No. 10, 01.10.2019, p. 1560-1570.

Research output: Contribution to journalReview article

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T1 - Exercise Parameters and Outcome Measures Used in Cardiac Rehabilitation Programs Following Median Sternotomy in the Elderly

T2 - A Systematic Review and Meta-Analysis

AU - Pengelly, Jacqueline

AU - Pengelly, Michael

AU - Lin, Kuan-Yin

AU - Royse, Colin

AU - Karri, Roshan

AU - Royse, Alistair

AU - Bryant, Adam

AU - Williams, Gavin

AU - El-Ansary, Doa

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N2 - Objective: The aim of this systematic review was to identify exercise parameters and outcome measures used in cardiac rehabilitation programs following median sternotomy, in the elderly cardiac population. Data Sources: Five (5) electronic databases were searched for relevant studies published in English after 1997. Study Selection: The screening process was completed by two independent researchers, with a third independent reviewer for overall agreement. Studies were selected if they included only cardiac patients aged ≥65 years who had undergone valve surgery and/or coronary artery bypass grafting via median sternotomy, and who had undertaken a postoperative cardiac rehabilitation exercise intervention assessing physical function and/or cognitive recovery as outcomes. Data Extraction: Two researchers independently completed the data extraction and quality assessment. Quality was assessed using a modified Downs and Black tool. Data Synthesis: In total, 11 articles were included for appraisal with respect to the quality of the study. Only two randomised controlled trials were suitable for meta-analysis. A higher volume of exercise was shown to have a positive effect on functional recovery, assessed using the 6-minute walk test (6MWT) (mean difference = 26.97 m; 95% confidence interval [CI], 6.96–46.97; p = 0.008; I2 = 0%). No significant improvement was shown between additional exercise compared to standard care in improving VO2peak, maximal power output or quality of life. No studies evaluated the effect of exercise on cognitive recovery. Conclusions: Exercise significantly improves functional recovery in the post-surgical elderly cardiac population, however uncertainty still exists with regard to which modes of exercise and their specific parameters are most effective in improving cognitive recovery.

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