Early strength training in cardiac surgery: how and what evidence?

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Presentation transcript:

Early strength training in cardiac surgery: how and what evidence? Scientific Programme endorsed by EAPC IRCCS POLICLINICO SAN DONATO, 26 Maggio 2018 FRAGILITA’ E CRONICITA’: NUOVE SFIDE IN RIABILITAZIONE CARDIOLOGICA Session 3 - Between myths, beliefs, commonplace and real world Early strength training in cardiac surgery: how and what evidence? Prof. Dr. Dominique Hansen, FESC Hasselt university Faculty of Medicine and Life Sciences Dominique.hansen@uhasselt.be

What is the impact of cardiothoracic surgery on skeletal muscles?

Cardiothoracic surgery and skeletal muscles anabolism catabolism catabolism anabolism Caso et al. Clin Sci 2008; 114: 339-46

Cardiothoracic surgery and skeletal muscles Change in fat mass = -1.4 kg Change in fat-free mass = -1.9 kg Exp Physiol 2015;100:818-28.

Cardiothoracic surgery and skeletal muscles Change in fat mass = -1.4 kg Change in fat-free mass = -1.9 kg Exp Physiol 2015;100:818-28.

Cardiothoracic surgery and skeletal muscles Exp Physiol 2015;100:818-28.

Cardiothoracic surgery and skeletal muscles Exp Physiol 2015;100:818-28.

Cardiothoracic surgery and skeletal muscles

Cardiothoracic surgery and skeletal muscles Is minimally invasive surgery better?

Cardiothoracic surgery and skeletal muscles Hansen D, et al. Am J Phys Med Rehabil. 2017;96:84-92.

Cardiothoracic surgery and skeletal muscles Hansen D, et al. Am J Phys Med Rehabil. 2017;96:84-92.

Cardiothoracic surgery and skeletal muscles

Cardiothoracic surgery and skeletal muscles

Cardiothoracic surgery has a significant adverse impact on skeletal muscle physiology, mass and function

So what can we do?

Impact of early endurance exercise

Safety precautions

This is not an effective intervention Group A: standard care Group B: passive cycling (2*30 min/day)

Strength training early after cardiac surgery: what is the evidence?

Strength training early after cardiac surgery: what is the evidence?

Strength training early after cardiac surgery: what is the evidence?

Strength training in immobile patients: what is the alternative?

Strength training in immobile patients: what is the alternative?

Other effective rehabilitation strategies?

Other effective rehabilitation strategies?

Other effective rehabilitation strategies?

Conclusions Cardiotharacic surgery has a significant negative impact on muscle physiology, function and mass In phase 2 rehabilitation, the addition of strength training to optimize muscle function is well- evidenced However, in phase 1 rehabilitation the impact, safety and modality selection of strength training remains to be studied in greater detail

Dominique.hansen@uhasselt.be