Core components of cardiac rehabilitation for people undergoing cardiac surgery: scoping review

Introduction: Currently, the number of heart surgeries has increased, being an end-of-line option when medical treatment fails to respond to individuals’ problems, aiming to repair the dysfunction of the heart’s mechanical functioning. Cardiac rehabilitation (CR) is a multidimensional intervention that includes education and the modification of cardiovascular risk factors in order to improve individuals’ quality of life. As a central component of CR programs, physical exercise is a strategy that promotes improved physical performance, as well as reduced symptoms associated with the disease and surgery. For these reasons, given the implications resulting from the pathological and surgical processes in patients undergoing cardiac surgery, it is necessary to define, implement and evaluate interventions that make it possible to minimize the functional impact on individuals affected by these conditions. Purpose: To map and analyze phase II CR programs that include individuals undergoing classic cardiac surgery, with a focus on physical exercise components. Methodology: Scoping Review (ScR) based on the principles advocated by the Joanna Briggs Institute. Two independent reviewers analyzed the relevance of the articles and extracted and synthesized the data. Eligibility criteria were defined as studies of any level of evidence, which clearly described the intervention performed in phase II of CR and whose target population included individuals undergoing coronary artery bypass grafting and heart valve surgery. An unlimited search was carried out in the EBSCOHost, Web of Science, Scopus and gray literature data sources. Results: 28 publications were included in this review. The intervention varies between 3 weeks and 12 months, with daily training sessions 2-5 times a week, lasting between 30 and 60 minutes. The intensity and type of exercise prescribed were areas with a wide dispersion, with the majority of studies favoring anaerobic training, of low to moderate intensity. Discussion: Most programs are evaluated at the beginning, middle and end of the program, using scales to measure quality of life, cardio respiratory capacity and functionality. The characteristics of the intervention, its duration and the evaluation instruments differ between the studies. Conclusion: Further research should be carried out in order to ascertain the range of criteria for the frequency, intensity, type and duration of physical exercise to be implemented in people undergoing cardiac surgery in phase II of CR. Mapping the interventions that could be used in phase II CR programs could help to determine the main components to be considered in intervention programs, for informed rehabilitation nursing decision-making, as well as identifying priority areas for research.