Table 1.
Subject and surgical variables
| CABG only | CABG + VR | VR only | Other OHS | p-value between OHS | Completers | Non-completers | p-value completer/non-completer | |
|---|---|---|---|---|---|---|---|---|
| Number of subjects (%) | 44 (58) | 9 (12) | 18 (24) | 5 (6) | N/A | 76 | 13 | N/A |
| Men (%) | 32 (73) | 7 (98) | 7 (39) | 4 (80) |
|
50 (66) | 13 (59) |
|
| Women (%) | 12 (27) | 2 (2) | 11 (61) | 1 (20) | 26 (34) | 9 (41) | ||
| Completers (%) | 44 (58) | 9 (12) | 18 (24) | 5 (6) |
|
76 (100) | NA | N/A |
| Non-completers (%) | 8 (36) | 3 (14) | 9 (41) | 2 (9) | N/A | 22 (100) | N/A | |
| Diabetic (%) | 9 (20) | 0 (0) | 1 (6) | 0 (0) | 0.17 | 10 (13) | 3 (14) | 0.95 |
| Using pre-op pain medication (%) | 8 (18) | 1 (11) | 1 (5) | 2 (40) | 0.27 | 12 (16) | 4 (18) | 0.79 |
| With pre-op shoulder disability (%) | 19 (43) | 3 (33) | 7 (39) | 0 (0) | 0.30 | 29 (38) | 12 (55) | 0.17 |
| With pre-op pain (%) | 26 (59) | 6 (66) | 13 (72) | 4 (80) | 0.67 | 49 (65) | 11 (50) | 0.22 |
| With previous injury/condition (%)a | 30 (68) | 6 (66) | 11 (61) | 4 (80) | 0.87 | 51 (67) | 15 (68) | 0.92 |
| Walking ≥1 km (pre-op) (%) | 17 (39) | 4 (44) | 7 (39) | 5 (100) | 0.07 | 33 (43) | 9 (41) | 0.83 |
| Walking ≥1 km (week 6) (%) | 30 (68) | 5 (56) | 10 (56) | 3 (60) | 0.76 | 48 (63) | N/A | N/A |
| Walking ≥1 km (week 12) (%) | 29 (66) | 4 (44) | 10 (56) | 4 (80) | 0.48 | 47 (62) | N/A | N/A |
| Walking 4+ times/week (week 6) (%) | 30 (68) | 5 (55) | 9 (50) | 3 (60) | 0.58 | 47 (62) | N/A | N/A |
| Walking 4+ times/week (week 12) (%) | 30 (68) | 3 (33) | 8 (44) | 3 (60) | 0.14 | 44 (58) | N/A | N/A |
| Using a walking aid (pre-op) (%)b | 2 (5) | 0 (0) | 2 (11) | 0 (0) | 0.56 | 4 (5) | 3 (14) | 0.18 |
| Using a walking aid (week 6) (%)b | 3 (7) | 0 (0) | 2 (11) | 0 (0) | 0.66 | 5 (7) | N/A | N/A |
| Using a walking aid (week 12) (%)b | 2 (5) | 0 (0) | 1 (6) | 0 (0) | 0.86 | 3 (4) | N/A | N/A |
| Trunk/limb exercises daily (%)c | 31 (71) | 4 (44) | 15 (83) | 2 (40) |
 d
|
52 (68) | N/A | N/A |
| Trunk/limb exercises 1–4/week (%)c | 12 (27) | 5 (56) | 3 (17) | 2 (40) | 22 (29) | N/A | N/A | |
| Trunk/limb exercises once/week (%)c | 1 (2) | 0 (0) | 0 (0) | 0 (0) | 1 (1) | N/A | N/A | |
| With post-op complications (%) | 24 (55) | 3 (33) | 10 (56) | 4 (80) | 0.40 | 41 (53) | 10 (46) | 0.48 |
| With post-op LOS >7 days (%) | 13 (30) | 5 (56) | 9 (50) | 2 (40) | 0.31 | 29 (38) | 9 (18)e | 0.81 |
| Sternal clicking (week 6) (%) | 3 (7) | 0 (0) | 5 (28) | 0 (0) | 0.05 | 8 (11) | N/A | N/A |
| Sternal clicking (week 12) (%) | 1 (2) | 0 (0) | 4 (22) | 0 (0) | 0.02 | 5 (7) | N/A | N/A |
| Mean age, years (SD) | 65.9 (8.7) | 69.6 (6.5) | 61.4 (13.2) | 50.4 (16.2) | 0.04f | 64.2 (11) | 59.1 (16.4) | 0.18 |
| Mean height, meters (SD) | 1.7 (0.1) | 1.7 (0.1) | 1.7 (0.1) | 1.8 (0.1) | 0.10 | 1.7 (0.1) | 1.7 (0.11) | 0.48 |
| Mean BMI, kg/m2 (SD) | 28.3 (3.8) | 26.3 (3.9) | 26.7 (6.4) | 24.5 (5.3) | 0.12 | 27.4 (4.7) | 28.7 (5.7) | 0.34 |
| Mean pre-op surgical risk score (SD) | 2 (1.4) | 2.4 (1.2) | 1.9 (1.3) | 1.8 (1.5) | 0.72 | 2 (1.3) | 2.3 (1) | 0.22 |
| Mean weeks of limb/trunk exercise (SD) | 3.5 (2) | 3.1 (1.6) | 4.2 (1.6) | 2.8 (1.3) | 0.33 | 3.6 (1.8) | N/A | N/A |
| Mean LOS, days (SD) | 8.8 (4.7) | 8.4 (1.7) | 10.4 (4.4) | 8.4 (1.1) | 0.06 | 9.12 (4.2) | 9.18 (4.8) | 0.96 |
| Mean bypass time, minutes (SD) | 74.2 (20.5) | 110 (19.9) | 103.8 (40.9) | 101.4 (44.8) | <0.001 | 87 (31.6) | 108.1 (78) | 0.23 |
| Mean X-clamp time, minutes (SD) | 52 (15.4) | 85.1 (17.7) | 61.2 (38) | 80 (39.6) | <0.001 | 60 (26.7) | 60.1 (34.8) | 0.99 |
| Mean SDS (pre-op)(SD) | 6.2 (14.7) | 2.4 (5.6) | 3.5 (6.2) | 0 (0) | 0.32 | 4.7 (11.8) | 3.1 (5.1) | 0.37 |
| Mean SDS (week 12) (SD) | 2.6 (5.5) | 1.0 (1.5) | 2.4 (3.5) | 0.8 (1.3) | 0.76 | 2.3 (4.6) | N/A | N/A |
| Mean TPS (pre-op) (SD) | 5.9 (10.2) | 4.9 (5.6) | 4.8 (7.7) | 5.6 (6.4) | 0.86 | 5.5 (8.9) | 4.7 (6.8) | 0.67 |
| Mean TPS (week 6) (SD) | 8.7 (9.8) | 8.8 (7.1) | 12.2 (14.3) | 5.4 (5.1) | 0.85 | 9.3 (10.6) | N/A | N/A |
| Mean TPS (week 12) (SD) | 4.8 (6.3) | 5.9 (8.0) | 6.5 (9.7) | 4.6 (8.1) | 0.84 | 5.3 (7.4) | N/A | N/A |
Notes: Other OHS included ascending aortic hemiarch replacement, atrial septal defect closure, redo pulmonary valve with right ventricular outflow tract repair, transaortic myomectomy. All tests between surgical groups were performed with Kruskal–Wallis test for median values. For comparisons for the completers versus non-completers, chi-squared test was used for categorical data and Student’s t-test (two-tailed for non-related groups) for numerical data.
Preoperative injury or conditions identified varied between surgical groups including: 1) CABG only: ankle and wrist, arthritis; arthritis in lower back; arthritis in spine; arthritis/muscle spasm in spine; arthritis; bilateral frozen shoulder, carpel tunnel (right); compressed spine; cut tendon hand (right); whiplash; degeneration of low back; dislocated shoulder as child; degeneration in the neck and back; disc problem; fall – fractured vertebrae; fell and hurt back; fell down a flight of stairs; fell over and damaged shoulder ligaments; football injury; forearm cut with chainsaw (left); fractured collar bone, fractured elbow; fractured metacarpal joint; fractured ribs; fractured wrist; graft surgery to left arm; hit and run – hurt back and right hand; lumbar disc problem; osteoarthritis of shoulder; osteoarthritis, pulled muscle lower back; rotator cuff shoulder (right), sciatica; scoliosis; Sherman’s disease in thoracic area; shoulder injury from fall; shoulder surgery (right); stiff neck; strained muscle; thumb and skull fracture; torn muscles; twisted back 30 years ago; whiplash. 2) CABG and valve only: finger arthritis; fractured wrist playing tennis; motor vehicle accident fractured neck/ribs + worn out disc; stiff neck, tendinitis elbow, strained back. 3) Valve only: arthritis; busted knuckle; cut tendon hand (left); cracked ribs; fell to the back/tennis elbow; long term aches and pains; neck injured in motor vehicle accident, tendon injury in shoulder; osteoarthritis back, had fallen over onto shoulder (right); osteoporosis; shoulder pain playing tennis (right), had fallen over hand and hurt shoulder (right); rotator cuff injury from fall; tennis elbow, pinched sciatic nerve. 4) Other OHS: neck injured in motor vehicle accident and tendon injury in shoulder; previous cardiac surgery; tight gluteal muscles; work injury to low back, shoulder pain (right) and upper back pain caused by heart surgery.
Walking aids included seat walkers, single sticks ×1–2; wheeled walker.
Trunk/limb exercise frequency was reported at week 6.
Missing data for one subject in the other OHS group.
Missing data for two subjects.
Pairwise comparisons of age for the surgical groups (Dunn’s method) was not significant (>0.05). Parentheses indicate that the p-value noted relates to the two lines (men and women), the two lines (completers and non-completers) and the three lines (trunk/limb exercsies - daily, 1–4 times/wk andonce/week).
Abbreviations: CABG, coronary artery bypass graft; LOS, length of stay; N/A, not applicable or not available; OHS, open-heart surgery; post-op, post-operation; pre-op, pre-operation; SDS, shoulder disability score; TPS, total pain score; VR, valve replacement/repair.