Comparison of the Effect of Cardiac Rehabilitation on Functional Capacity of Diabetic and Nondiabetic Patients after CABG

Taliie Shafaee, Mostafa Rad, Seyed Reza Mazloom, Sedigheh Rastaghi, Zahra Hamedi

Abstract


Background: After a coronary artery bypass graft (CABG), diabetic patients deal with various hemodynamic disorders. This study aimed to compare the effect of cardiac rehabilitation (CR) on the functional capacity of diabetic and nondiabetic patients following CABG.

Methods: This descriptive‑analytical study was performed on 40 diabetic and nondiabetic patients attending a similar CR program following CABG. The subjects were selected by convenience sampling and were divided into two diabetes and nondiabetes groups. All patients attended 24 exercise sessions held 3 days a week. The functional capacity of patients was measured and recorded with the metabolic equivalent of Task criterion before and after the CR program. In addition, data analysis was performed in SPSS version 19.

Results: In this study, the mean age of the diabetic and nondiabetic patients was 54.45 ± 5.82 and 56.85 ± 5.36 years, respectively. There was no significant difference between the research groups regarding the systolic and diastolic blood pressure (P > 0.05). The mean functional capacity in the diabetes and nondiabetes groups was 4.5 ± 0.79 and 5.2 ± 1.7 before the rehabilitation, respectively. However, the results of Mann–Whitney U‑test were indicative of a lack of a significant difference in this respect (P > 0.05). After the CR program, the mean functional capacity in the diabetes and nondiabetes groups was 5.7 ± 1.31 and 6.3 ± 1.7, respectively, demonstrating an insignificant difference in this regard (P > 0.05).

Conclusions: According to the results of the study, there was no significant difference between the diabetic and nondiabetic patients, who underwent CABG, after a CR program. However, replication of the study is warranted.


Keywords


Cardiac rehabilitations; coronary artery bypass; diabetes mellitus; metabolic equivalent

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References


Jahanbakhsh M, Ehteshami A, Afkhami S. Developing “Aryan:”

Diabetes self‑care mobile application. Int J Prev Med 2019;10:59.

Honarvar B, Banakar M, Hassani N, Movahednezhad Y,

Gheibi Z, Bagheri Lankarani K. From iceberg of pre‑diabetes

to poor glycemic control in diabetics: An elderly based study in

Shiraz, South of Iran. Int J Prev Med 2019;10:171.

Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E,

Nauck M, et al. Management of hyperglycemia in type 2

diabetes, 2015: A patient‑centered approach: Update to a

position statement of the American diabetes association and the

European association for the study of diabetes. Diabetes Care

;38:140‑9.

Kouhestani HR, Baghcheghi N, Zand S. Impact of teaching cardiac rehabilitation programs on electrocardiogram changes

among patients with myocardial infraction. IJNR 2010;5:6‑12.

de Macedo RM, Faria‑Neto JR, Costantini CO, Casali D,

Muller AP, Costantini CR, et al. Phase I of cardiac rehabilitation:

A new challenge for evidence based physiotherapy. World J

Cardiol 2011;3:248‑55.

Rion JH, Kautz DD. The walk to save: Benefits of inpatient

cardiac rehabilitation. Medsurg Nurs 2016;25:159‑63.

Jamshidpour B, Attarbashi Moghaddam B, Vassaghi B, Mirzaii E,

Nejatian M. The effects of cardiac rehabilitation on changes in

anthropometric measurements of obesity among diabetic and non

diabetic men with coronary artery disease referred to cardiac

rehabilitation. J Mod Rehabil 2012;6:30‑6.

Lavie CJ, Arena R, Swift DL, Johannsen NM, Sui X, Lee D‑c,

et al. Exercise and the cardiovascular system: Clinical science

and cardiovascular outcomes. Circ Res 2015;117:207‑19.

Jones MI, Greenfield S, Jolly K. Patients’ experience of home

and hospital based cardiac rehabilitation: A focus group study.

Eur J Cardiovasc 2009;8:9‑17.

Sandesara PB, Lambert CT, Gordon NF, Fletcher GF,

Franklin BA, Wenger NK, et al. Cardiac rehabilitation and risk

reduction: Time to “rebrand and reinvigorate”. J Am Coll Cardiol

;65:389‑95.

Lange K, Swift P, Pańkowska E, Danne T. Diabetes education

in children and adolescents. Pediatr Diabetes 2014;15(Suppl.

:77‑85.

Abaci A, Oğuzhan A, Kahraman S, Eryol NK, Unal S,

Arinç H, et al. Effect of diabetes mellitus on formation of

coronary collateral vessels. Circulation 1999;99:2239‑42.

Marks JB, Raskin P. Cardiovascular risk in diabetes: A brief

review. J Diabetes Complications 2000;14:108‑15.

Gu K, Cowie CC, Harris MI. Mortality in adults with and

without diabetes in a national cohort of the US population,

–1993. Diabetes Care 1998;21:1138‑45.

Anderson L, Oldridge N, Thompson DR, Zwisler A‑D,

Rees K, Martin N, et al. Exercise‑based cardiac rehabilitation

for coronary heart disease: Cochrane systematic review and

meta‑analysis. J Am Coll Cardiol 2016;67:1‑12.

Davies EJ, Moxham T, Rees K, Singh S, Coats AJ, Ebrahim S,

et al. Exercise training for systolic heart failure: Cochrane

systematic review and meta‐analysis. Eur J Heart Fail

;12:706‑15.

Ebrahimi M, Kazemi‑Bajestani S, Ghayour‑Mobarhan M,

Ferns G. Coronary artery disease and its risk factors status in

Iran: A review. Iran Red Crescent Med J 2011;13:610‑23.

Nichols M, Townsend N, Scarborough P, Rayner M.

Cardiovascular disease in Europe: Epidemiological update. Eur

Heart J 2013;34:3028‑34.

Andraos C, Arthur HM, Oh P, Chessex C, Brister S, Grace SL.

Women’s preferences for cardiac rehabilitation program

model: A randomized controlled trial. Eur J Prev Cardiol

;22:1513‑22.

Abdella NA, Mojiminiyi OA. Clinical applications of

adiponectin measurements in type 2 diabetes mellitus:

Screening, diagnosis, and marker of diabetes control. Dis

Markers 2018;2018:5187940.

McPhee PG, Winegard KJ, MacDonald MJ, McKelvie RS,

Millar PJ. Importance of early cardiac rehabilitation on changes

in exercise capacity: A retrospective pilot study. Appl Physiol

Nutr Metab 2015;40:1314‑7.

Pilannejad S, Naimi SS, Okhovatian F, Attarbashi MB,

Jamalian SA, Akbarzadeh BA. Effect of the first phase of cardiac

rehabilitation on quality of life and functional capacity of patients

with heart failure. Scientific J Rehabil Med 2017;6:82‑90.

Saremi A, Sadeghi M, Shahrjerdi S, Hashemi S. An eight‑weeks

cardiac rehabilitation program in patients with coronary artery

diseases: Effects on chronic low‑grade inflammation and

cardiometabolic risk factors. Payesh 2017;16:160‑9.

El Demerdash S, Khorshid H, Salah I, Abdel Rahman MA,

Salem AM. Cardiac rehabilitation improves the ischemic burden

in patients with ischemic heart disease who are not suitable for

revascularization. Cardiovasc Revasc Med 2015;16:280‑3.

Siegmund LA, Albert NM, McClelland MS, Bena JF,

Morrison SL. Functional capacity but not early uptake of cardiac

rehabilitation predicts readmission in patients with metabolic

syndrome. J Cardiovasc Nurs 2018;33:306‑12.




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