Prehabilitation for elective coronary artery bypass grafting surgery
Scoping review identifies various knowledge gaps about prehabilitation in cardiac surgery
Preoperative interventions (also known as prehabilitation) aim to improve the safety and outcome of surgical intervention, and they can also increase patient motivation in postoperative rehabilitation and decrease recovery time. Prehabilitation can include exercise interventions, nutrition recommendations, behavioural changes, and cognitive training.
For patients undergoing elective coronary artery bypass grafting surgery to derive benefit from prehabilitation, methodologically robust clinical trials and knowledge syntheses are required to identify optimal strategies for patient selection, intervention design, adherence, and intervention duration.
A new scoping review examined prehabilitation interventions to optimise outcomes after elective coronary artery bypass grafting surgery. The aims of the interventions examined in the 67 studies included in the scoping review were to reduce the risk of complications, improve functional recovery, and shorten length of stay for adult patients waiting for elective coronary artery bypass grafting surgery at home.
The scoping review identified various gaps in knowledge about prehabilitation in cardiac surgery, and found that available evidence is mostly based on small studies with high heterogeneity.
A number of suggested areas for future research and guideline development are outlined in the scoping review. These include a focus on determining the optimal duration and frequency of interventions to improve postoperative outcomes, and the cost-effectiveness of prehabilitation interventions before elective coronary artery bypass grafting surgery.
The authors also suggest that future research should focus on improving adherence and meaningfulness of prehabilitation programs for patients awaiting elective coronary artery bypass grafting surgery. If interventions are to be effective, it is important that patients find them meaningful. Therefore, qualitative studies are needed to evaluate the meaningfulness and appropriateness of individual interventions for patients.
The scoping review is published in the June 2023 issue of JBI Evidence Synthesis.
Prehabilitation before elective coronary artery bypass grafting surgery: a scoping review
Olsen, Dorte Baek; Pedersen, Preben; Noergaard, Marianne Wetendorff
JBI Evidence Synthesis 21(6):p 1190-1242, June 2023. | DOI: 10.11124/JBIES-22-00265