Effect of short-term exercise training on aerobic fitness in patients with abdominal aortic aneurysms: a pilot study

Hdl Handle:
http://hdl.handle.net/10149/91847
Title:
Effect of short-term exercise training on aerobic fitness in patients with abdominal aortic aneurysms: a pilot study
Authors:
Kothmann, E.; Batterham, A. M. (Alan); Owen, S. J.; Turley, A. J. (Andre); Cheesman, M.; Parry, A.; Danjoux, G. R. (Gerry)
Affiliation:
Teesside University. School of Health and Social Care. Health and Social Care Institute.
Citation:
Kothmann, E. et al. (2009) 'Effect of short-term exercise training on aerobic fitness in patients with abdominal aortic aneurysms: a pilot study', British Journal of Anaesthesia, 103 (4), pp.505-510.
Publisher:
Oxford University Press
Journal:
British Journal of Anaesthesia
Issue Date:
Oct-2009
URI:
http://hdl.handle.net/10149/91847
DOI:
10.1093/bja/aep205
Abstract:
Background: Patients with abdominal aortic aneurysms (AAA) represent a high-risk surgical group. Despite medical optimization and radiological stenting interventions, mortality remains high and it is difficult to improve fitness. The aim of this pilot study was to evaluate the effect of a 6 week, supervised exercise programme (30 min continuous moderate intensity cycle ergometry, twice weekly) on anaerobic threshold (AT) in subjects with AAA. Methods: Thirty participants with an AAA under surveillance were randomized to either the supervised exercise intervention (n=20) or a usual care control group (n=10). AT was measured using cardiopulmonary exercise testing, at baseline (AT1), week 5 (AT2), and week 7 (AT3). The change in AT (AT3–AT1) between the groups was compared using a mixed model ANCOVA, providing the mean effect together with the standard deviation (SD) for individual patient responses to the intervention. The minimum clinically important difference (MCID) was defined as an improvement in AT of 2 ml O2 kg–1 min–1. Results: Of the 30 participants recruited, 17 of 20 (exercise) and eight of 10 (control) completed the study. The AT in the intervention group increased by 10% (equivalent to 1.1 ml O2 kg–1 min–1) compared with the control (90% confidence interval 4–16%; P=0.007). The SD for the individual patient responses to the intervention was 8%. The estimated number needed to treat (NNT) for benefit was 5 patients. Conclusions: The small mean benefit was lower than the MCID. However, the marked variability in the individual patient responses revealed that a proportion of patients did benefit clinically, with an estimated NNT of 5.
Type:
Article
Language:
en
Keywords:
assessment; preanaesthetic; surgery; vascular
ISSN:
0007-0912; 1471-6771
Rights:
Subject to restrictions, author can archive post-print (ie final draft post-refereeing). For full details see http://www.sherpa.ac.uk/romeo/ [Accessed 11/02/2010]
Citation Count:
0 [Scopus, 11/02/2010]

Full metadata record

DC FieldValue Language
dc.contributor.authorKothmann, E.en
dc.contributor.authorBatterham, A. M. (Alan)en
dc.contributor.authorOwen, S. J.en
dc.contributor.authorTurley, A. J. (Andre)en
dc.contributor.authorCheesman, M.en
dc.contributor.authorParry, A.en
dc.contributor.authorDanjoux, G. R. (Gerry)en
dc.date.accessioned2010-02-11T15:12:07Z-
dc.date.available2010-02-11T15:12:07Z-
dc.date.issued2009-10-
dc.identifier.citationBritish Journal of Anaesthesia; 103 (4): 505-510en
dc.identifier.issn0007-0912-
dc.identifier.issn1471-6771-
dc.identifier.doi10.1093/bja/aep205-
dc.identifier.urihttp://hdl.handle.net/10149/91847-
dc.description.abstractBackground: Patients with abdominal aortic aneurysms (AAA) represent a high-risk surgical group. Despite medical optimization and radiological stenting interventions, mortality remains high and it is difficult to improve fitness. The aim of this pilot study was to evaluate the effect of a 6 week, supervised exercise programme (30 min continuous moderate intensity cycle ergometry, twice weekly) on anaerobic threshold (AT) in subjects with AAA. Methods: Thirty participants with an AAA under surveillance were randomized to either the supervised exercise intervention (n=20) or a usual care control group (n=10). AT was measured using cardiopulmonary exercise testing, at baseline (AT1), week 5 (AT2), and week 7 (AT3). The change in AT (AT3–AT1) between the groups was compared using a mixed model ANCOVA, providing the mean effect together with the standard deviation (SD) for individual patient responses to the intervention. The minimum clinically important difference (MCID) was defined as an improvement in AT of 2 ml O2 kg–1 min–1. Results: Of the 30 participants recruited, 17 of 20 (exercise) and eight of 10 (control) completed the study. The AT in the intervention group increased by 10% (equivalent to 1.1 ml O2 kg–1 min–1) compared with the control (90% confidence interval 4–16%; P=0.007). The SD for the individual patient responses to the intervention was 8%. The estimated number needed to treat (NNT) for benefit was 5 patients. Conclusions: The small mean benefit was lower than the MCID. However, the marked variability in the individual patient responses revealed that a proportion of patients did benefit clinically, with an estimated NNT of 5.en
dc.language.isoenen
dc.publisherOxford University Pressen
dc.rightsSubject to restrictions, author can archive post-print (ie final draft post-refereeing). For full details see http://www.sherpa.ac.uk/romeo/ [Accessed 11/02/2010]en
dc.subjectassessmenten
dc.subjectpreanaestheticen
dc.subjectsurgeryen
dc.subjectvascularen
dc.titleEffect of short-term exercise training on aerobic fitness in patients with abdominal aortic aneurysms: a pilot studyen
dc.typeArticleen
dc.contributor.departmentTeesside University. School of Health and Social Care. Health and Social Care Institute.en
dc.identifier.journalBritish Journal of Anaesthesiaen
ref.citationcount0 [Scopus, 11/02/2010]en
or.citation.harvardKothmann, E. et al. (2009) 'Effect of short-term exercise training on aerobic fitness in patients with abdominal aortic aneurysms: a pilot study', British Journal of Anaesthesia, 103 (4), pp.505-510.-
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