Effect of Supervised Versus Home Based Cardiac Rehabilitation on Heart Rate Recovery in Patients with Coronary Artery bypass Grafting

The autonomic dysfunction is known to adversely affect clinical outcome in patients with cardiovascular disease, and exercise has been shown to modify the symparthovagal control of heart rate. The purpose of this study was to investigate the effects of four week's supervised and home based phase II cardiac rehabilitation (CR) on Heart rate recovery (HRR) in patient with coronary artery bypass grafting (CABG) after 6 minute walk test.

A prospective, randomized, comparative study.

Cardiopulmonary Physical therapy Department, National Heart Institute (All India Heart Foundation) East of Kailash, New Delhi.

Thirty patients having undergone CABG were randomly assigned to two groups. Group A (n=15) included patients who underwent a supervised exercise program at physiotherapy outpatient department, and Group B (n=15) included patients who underwent home exercise program at their residence. HRR was measured at discharge (baseline test) and after four weeks of phase II CR (follow up test) following a 6 minute walk test.

Data was analyzed using SPSS 15.0. At follow up, both the groups had a significantly higher recovery of heart rates over 2 minutes (p<0.05) compared to their baseline measurements.

Our results point out that a four weeks phase II cardiac rehabilitation program has positive effect on HRR in patients having undergone CABG in both the groups and is consistent with autonomic improvement. Home based phase II CR is equally effective in improving heart rate reserve as compared to supervised exercise group. Similar improvements of HRR in both the groups strengthens the rationale for promoting home based exercise program, as the patients need not have to visit hospital regularly for a supervised exercise program.