1. 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

2. What is the impact of cardiothoracic surgery on skeletal muscles?

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

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

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

6. Cardiothoracic surgery and skeletal muscles
Exp Physiol 2015;100:  

7. Cardiothoracic surgery and skeletal muscles
Exp Physiol 2015;100:  

8. Cardiothoracic surgery and skeletal muscles

9. Cardiothoracic surgery and skeletal muscles
Is minimally invasive surgery better?

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

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

12. Cardiothoracic surgery and skeletal muscles

13. Cardiothoracic surgery and skeletal muscles

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

15. So what can we do?

18. Impact of early endurance exercise

20. Safety precautions

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

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

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

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

29. Strength training in immobile patients: what is the alternative?

30. Strength training in immobile patients: what is the alternative?

31. Other effective rehabilitation strategies?

32. Other effective rehabilitation strategies?

33. Other effective rehabilitation strategies?

34. 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