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Heart, Lung and Circulation

Effects of 12-Week Supervised Early Resistance Training (SEcReT) Versus Aerobic-Based Rehabilitation on Cognitive Recovery Following Cardiac Surgery via Median Sternotomy: A Pilot Randomised Controlled Trial

  • Jacqueline Pengelly
    Correspondence
    Corresponding author at: Office 330, Building P, Mount Helen Campus, PO Box 663, Federation University Australia, Mount Helen, Vic. 3353, Australia.
    Affiliations
    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
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  • Colin Royse
    Affiliations
    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
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  • Gavin Williams
    Affiliations
    Department of Physiotherapy, University of Melbourne, Melbourne, Vic, Australia
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  • Adam Bryant
    Affiliations
    Department of Physiotherapy, University of Melbourne, Melbourne, Vic, Australia
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  • Sandy Clarke-Errey
    Affiliations
    Statistical Consulting Centre, University of Melbourne, Melbourne, Vic, Australia
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  • Alistair Royse
    Affiliations
    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
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  • Doa El-Ansary
    Affiliations
    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
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Published:October 06, 2021DOI:https://doi.org/10.1016/j.hlc.2021.08.023

      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.

      Keywords

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