Exercise Performance in Post-Surgery Cardiac Rehabilitation in Women and Elderly

Objective: We hypothesized that post-cardiac surgery rehabilitation (CR) has different efficacy on physical fitness recovery according to gender and age subgroups. Design: 677 post-cardiac surgery CR patients were analyzed, both at admission and at discharge, for fitness and echocardiographic data. Results: At admission, females walked a lower distance at 6-minute walking test, were more compromised in Barthel scale, had lower VO2 max (p < 0.001 for all) and a worse perception of effort (p = 0.001) compared to male. They similarly improved at discharge in all parameters (p < 0.001), except for metres walked (p = 0.004). Elderly patients (> median of 68 years) had lower VO2 max at admission (p < 0.001) and improved similarly to adult patients at discharge (p < 0.001), except for metres walked (p < 0.001). CR produced increment of EF by 10% in patients with reduced and 3% in those with preserved EF (p = 0.0002). Physical fitness and E/E’ significantly improved in both EF groups. E/E’ was greater in elderly patients at admission (p = 0.011) and similarly reduced in both age groups (p < 0.001) after CR. Conclusion: CR projects should be personalized not only in terms of modalities, volume and intensity of exercise, but also according to the length of hospital stay, taking into consideration gender and age physical fitness peculiarities.