PREhabilitation in Patients Awaiting Acute Inpatient Cardiac SurgEry

Summary

This is a single centre, single arm pilot feasibility study to determine the feasibility and practicality of prehabilitation in acute inpatients waiting for cardiac surgery. We will be looking into participant eligibility, acceptability, recruitment rates, completion rates and barriers to implementing a prehabilitation programme. Secondary outcomes include safety (incidence of adverse events directly related to the study), improvement in 6 minutes walk test (6MWT), hand grip strength, quality of life, and spirometry. At the end of the trial, we will be seeking the feedback of the participants to help us improve the design further.

Eligibility

Inclusion Criteria:

* All patients over the age of 18 scheduled for acute cardiac surgery in CHH will be given consideration to participate in this clinical trial.

Exclusion Criteria:

* Patients who are unable or unwilling to participate in any of the elements of prehabilitation will be excluded. These include those that have cognitive disability (including unconsciousness), cardiac or clinical instability, functional or anatomical impairment which impairs ability to participate, language barrier or patient refusal. Patients that have impending surgery within 72 hours of arrival to hospital will be excluded. Patients who are awaiting surgery in district hospitals or outside of Castle Hill Hospital will be excluded. A non-exhaustive list of exclusion criteria is included below.

Cardiac/ clinical instability such as:

* Recurrent unstable angina/ crescendo angina
* Untreated decompensated heart failure
* Malignant arrhythmias awaiting treatment
* Resting tachycardia (HR\>100 bpm)
* Left ventricular outflow obstruction such as Aortic Stenosis with pre-syncopal or syncopal symptoms
* Unresolved acute pericarditis or myocarditis
* Second or third degree heart block without pacemaker
* Aortic Dissection
* Myxoma

Functional/ anatomical impairment such as:

* Severe musculoskeletal conditions that would prohibit exercise
* Amputees
* Registered blind

Conditions6

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