Home-based prehabilitation for frail cardiac surgery patients (HOME FREE) - a quasi-experimental feasibility study
| dc.contributor.author | Codispodi, Kelly | |
| dc.contributor.examiningcommittee | Strachan, Shaelyn (Kinesiology and Recreation Management) | |
| dc.contributor.examiningcommittee | Cornish, Stephen (Kinesiology and Recreation Management) | |
| dc.contributor.supervisor | Duhamel, Todd | |
| dc.contributor.supervisor | Arora, Rakesh | |
| dc.date.accessioned | 2024-08-30T15:37:27Z | |
| dc.date.available | 2024-08-30T15:37:27Z | |
| dc.date.issued | 2024-08-26 | |
| dc.date.submitted | 2024-08-26T12:50:17Z | en_US |
| dc.degree.discipline | Kinesiology and Recreation Management | |
| dc.degree.level | Master of Science (M.Sc.) | |
| dc.description.abstract | Introduction: Frailty is a syndrome characterized by loss of muscle mass, strength, and difficulty completing activities of daily living. It’s presence in patients undergoing major surgical procedure is associated with prolonged postoperative recovery, resulting in functional decline and increased rates of morbidity and mortality. Methods: A prospective, quasi-experimental study was conducted on pre-frail and frail patients undergoing cardiac surgery at St. Boniface Hospital. Patient’s with an estimated wait time of ≥ 3 weeks for their surgical procedure and who scored ≤ 60 on the short form 36 physical functioning scale were approached to participate in a 100% virtually delivered preoperative home-based exercise intervention. Participants were assessed and prescribed standardized exercises over Zoom and monitored via weekly Zoom conferencing with a physiotherapist (4 sessions over 3 weeks). The program focused on balance and strengthening exercises 3 x/week at a moderate intensity. The primary outcome was the feasibility and practicality of the intervention, defined as a consent rate of ≥ 30% of eligible patients as well as an adherence rate of ≥ 65% to the prescribed exercise program. Secondary outcomes evaluated safety and exploratory efficacy of the home-based program. Results: Among 209 screened patients, only 27 met the eligibility criteria. Nine of the 27 consented to participate, 2 were lost due to early surgical dates and 1 dropped out. Visit data of 6 participants were analyzed and their adherence to exercise was > 75%, with proper exercise technique demonstrated 88% of the time. No safety events occurred and clinically meaningful change in the SPPB score was demonstrated with an effect size of d = -0.99. Gait speed also improved clinically and statistically with a p = 0.026, and effect size of d = -1.57. Conclusion: Feasibility was demonstrated with a consent rate of 33% and an adherence to the exercise protocol of > 75%. Participants safely completed the virtually delivered prehabilitation program and effect sizes were determined to inform future trials. Researchers should test the efficacy of virtually delivered preoperative home-based exercise programming for patients who will undergo cardiac surgery. Eligibility criteria should be expanded to optimize participation in prehabilitation. | |
| dc.description.note | October 2024 | |
| dc.identifier.uri | http://hdl.handle.net/1993/38469 | |
| dc.language.iso | eng | |
| dc.rights | open access | en_US |
| dc.subject | Prehabilitation | |
| dc.subject | Cardiac Surgery | |
| dc.subject | Frailty | |
| dc.subject | Telerehabilitation | |
| dc.subject | Home-based Exercise | |
| dc.title | Home-based prehabilitation for frail cardiac surgery patients (HOME FREE) - a quasi-experimental feasibility study | |
| dc.type | master thesis | en_US |
| local.subject.manitoba | yes |