Effect of Metabolic Equivalent-Based Bicycle Ergometer Exercise Training on Functional Outcomes in Phase I Cardiac Rehabilitation: A Non-Randomized Controlled Trial
Abstract
Objective: Patients undergoing cardiac surgery often experience impaired physical activity and exercise capacity. Safety concerns, including anxiety and fear of unsupervised walking, limit optimal exercise training in the early phase. Metabolic equivalent-based (MET) bicycle ergometer training is another option with quantifiable measures for early exercise training. The unexplored benefits of such training warranted this study. We aimed to compare its efficacy with traditional care in phase I cardiac rehabilitation among a post-cardiac surgery population.
Material and Methods: In this non-randomized controlled trial, eligible subjects were patients who had undergone adult cardiac surgeries, such as Coronary Artery Bypass Grafting and Valve Replacement, of both genders, aged 30-70 years, with an LVEF greater than 50%, and an uncomplicated postoperative period. Subjects were allocated either to the control or study group. Subjects with high cardiac risk and musculoskeletal and neurological dysfunction were excluded. The study and control groups received MET-based bicycle ergometer training and routine hospital care, respectively. Functional capacity and Left Ventricular Ejection Fraction were measured before and after training. Physiological response was monitored before, during, and after training in all subjects.
Results: Thirty patients completed the trial (15 in each group), with 5 dropouts in each group. Baseline characteristics were similar. Physiological response during MET-based exercise was found to be within safe limits. Functional capacity improved significantly in the study group (228.2m) compared with the control group (74m), with a p-value<0.001. Improvement in Left Ventricular Ejection Fraction was significant in both groups.
Conclusion: MET-based bicycle ergometer training was found to be feasible, safe, and had a clinically significant impact on functional capacity.
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