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Keywords:

  • very old;
  • RCT ;
  • functional capacity;
  • quality of life;
  • cardiac rehabilitation

Objectives

To compare the efficacy of intensive functional exercise training with that of usual cardiac rehabilitation (CR) in very old adults soon after coronary bypass surgery (CABG).

Design

Randomized controlled trial.

Setting

In-hospital CR.

Participants

Individuals aged 75 and older (n = 173, mean 78.5 ± 3.2) participated in inpatient CR, which started soon after surgery (13.1 ± 5.3 days) and lasted for a mean of 20.4 ± 3.2 days.

Intervention

Participants were randomly assigned to an inpatient CR intervention group (IG; n = 84) or a control group (CG; n = 89). All participants participated in the inpatient CR program. In addition, IG participants participated in resistance training and special balance training (5 d/wk).

Measurements

Six-minute walk test, cardiopulmonary exercise testing, Timed-Up-and-Go Test (TUG), and a maximal isometric strength test were used to access functional capacity and the MacNew questionnaire to evaluate health-related quality of life (HRQL).

Results

There were significant improvements (P < .001) in all measured variables over the duration of CR. Improvements in functional capacity were significantly greater in the IG than the CG for 6-minute walk distance (6-MWD) (IG Δ 67.3 ± 49.0 m vs CG Δ 41.9 ± 51.7 m; P = .003), TUG time (IG Δ −2.4 ± 2.2 seconds vs CG Δ −1.2 ± 3.4 seconds; P = .005), and relative workload (IG Δ 0.19 ± 0.21 W/kg vs CG Δ 0.13 ± 0.11 W/kg; P = .03).

Conclusion

There were significant improvements in all measured variables in very old adults participating in CR soon after CABG. With additional functional exercise training, participants randomized to IG improved significantly more than those randomized to CG on 6-MWD, TUG time, and relative workload.