What?
Around 35,000 patients have heart surgery in the UK every year. It is well known that patients who are less active and have more health problems are more likely to have complications after their heart surgery.
Patients currently receive a period of heart rehabilitation after their surgery to help them recover and get back to as full a life as possible, but it is now recognised that an exercise programme carried out prior to surgery (called prehabilitation) might improve recovery and quality of life post surgery.
The aim of this trial was to find out if prehabilitation improves exercise capacity prior to surgery.
PrEPS Trial video
This short video explains the aims and design of this trial, followed by a summary of results.
The trial was funded Heart Research UK and published in Anaesthesia.
How?
180 eligible and consenting patients who were due to be having heart surgery were split into two groups.
One group received the standard advice given prior to surgery and the other group took part in a four week prehabilitation programme consisting of twice weekly supervised exercise classes, a home exercise programme and breathing exercises.
All participants completed a questionnaire about their general health and had a fitness test before and after their surgery. These data was analysed to determine which group did better before and after their surgery.
Chief investigator
Enoch Akowuah
Current status
This trial is now complete and results were published in July 2023. Below is a summary of findings;
- We found that overall, patients who took the prehabilitation programme did not have better ability to exercise at the end compared to patients who had not taken the programme.
- However, there was a group of patients who did do better when they took the prehabilitation programme; these were patients who were frail.
- The muscles used for breathing were stronger in the patients in the prehabilitation group for up to 12 weeks after surgery.
- Most patients (three out of every four patients) in the prehabilitation group were able to attend the exercise classes and also completed exercise at home.
- We found that most of the problems (complications) patients had were not caused by the prehabilitation programme.
- Overall the combination of exercise and breathing muscle training used in this prehabilitation programme seemed to be okay to complete, and did not cause harm to patients.
- This trial didn’t show that prehabilitation was better, but we think more trials that include patients who are frail are needed. We think these future trials should look at the breathing exercises in more detail.
Participating sites
South Tees Hospitals NHS Foundation Trust.