Feasibility and effectiveness of home-based phase III exercise program for frail patients after heart surgery: results of a pilot study
Bibliographic record
Abstract
Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Research Council of Lithuania Introduction The number of elderly frail patients after cardiac surgery is increasing. Frailty has become an important burden to be treated in cardiac rehabilitation (CR). Purpose To evaluate feasibility and effectiveness of home-based exercise program including endurance, flexibility, sensomotoric and resistance training specially tailored for elderly frail patients after open heart surgery. Methods A pilot study of a prospective, single-center, randomized controlled trial. Inclusion criteria: CR after open heart surgery, age ≥ 65 years, Edmonton frailty scale (EFS) score ≥ 4, patient’s agreement to participate in the study. A sample of 30 Patients (73.1±4.16 years, 73% male, EFS-score 5.68±0.28) were randomly assigned to intervention group (IG n=17) or control group (CG n=13). All patients completed comprehensive 20-days inpatient CR program, including aerobic cycle ergometer training (30 min, 6 sessions/week), sensomotoric and flexibility training (15 min. 3d/w for each), resistance training (25 min, 3 d/w) and respiratory exercises (15 min, 5 days/week). After completion of inpatient-CR, the intervention group (IG) participated in a 12-week home-based exercise program including 30 to 45 minutes exercise sessions on 5 days/week, with endurance, flexibility, balance, and resistance training of low to moderate intensity. IG-participants received baseline instructions and the participation was monitored by telephone calls every second week. The CG received usual care. The 6-minutes-walking-test (6MWT) was used to assess functional capacity, the EFS to assess frailty level. Examination times were baseline, after 20-days CR and 12 weeks after completion of CR. Repeated measures ANOVA was used for statistical analysis. Results Baseline evaluation revealed good comparability of the groups showing significant difference only in the gender distribution (age IG 73.2±0.97 years vs. CG 73.5±1.59 years), p=0.722), frailty level (EFS score CG 6.3±0.4 vs. 5.58±0.35, p=0.56), functional capacity (6MWD IG 285.94±19.92 m. vs. CG 309.62±21.55 m, p=0.430, gender distribution IG were 9 (53%) males vs. CG 13 (100%), p=0.04). Main results are summarized in Table 1. The results show significant improvements in EFS-score and 6MWD over the observation time with no differences between the groups. The home-based program was feasible and safe for the IG, and no adverse effects or events occurred that led to premature discontinuation of study participation. Conclusions The specially tailored home-based-program for elderly frail patients after open heart surgery was well accepted and tolerated by the patients. The results are promising, but probably because of the small sample size, no significant differences were found between the groups in the degree of frailty or functional capacity.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".