Efficacy And Safety Of Exercise Rehabilitation In Postoperative Patients With Valvular Heart Disease:A Meta-analysis Of RCTs

Objective:Evaluating the efficacy and safety of exercise rehabilitation（ER）in postoperative patients with valvular heart disease（VHD）.Methods:By searching the online databases of Cochrane,Embase,Web of Science,Scopus,PubMed,CNKI,Wanfang Data,etc.,to collect the randomized controlled trials（RCTs）,concerning the efficacy and safety about ER intervention combined with conventional treatment in postoperative patients with VHD,which were published before the end of October 2020.Extracted the data from these RCTs and performed statistical analysis by Rev Man5.3 software.Results:Twelve RCTs were included in the analysis.This meta-analysis indicated that compared with conventional treatment in postoperative patients with VHD,ER’s hospital stays got shorter[WMD:-3.20;95%CI（-5.07,-1.33）;P=0.0008].According to the results of subgroup analysis about type of hospital stays showed that compared with conventional treatment in postoperative patients with VHD,hospital stays got shorter with the people who accepted ER after operation[WMD:-4.22;95%CI（-6.26,-2.18）;P<0.0001].However,the people who accepted ER before operation did not[WMD:-0.05;95%CI（-2.59,2.50）;P=0.97].Besides,left ventricular ejection fraction（LVEF）[WMD:8.51;95%CI（6.08,10.94）;P<0.00001]and peak oxygen uptake（VO₂peak）[WMD:2.12;95%CI（0.14,4.10）;P=0.04]were improved with ER.Nevertheless,there was no significant difference in the 6-minute walk test（6MWT）[WMD:26.86;95%CI（-13.77,67.49）;P=0.20].For the quality of life evaluation,the ER showed improvement only in Role-Emotional[WMD:6.04;95%CI（1.61,10.48）;P=0.008].However,there was no significant difference in Role-Physical[WMD:3.05;95%CI（-1.66,7.76）;P=0.20],Bodily Pain[WMD:8.10;95%CI（-1.28,17.48）;P=0.09]and Mental Health[WMD:-1.36;95%CI（-11.75,9.02）;P=0.80).In addition,ER was with a lower risk of adverse events[RR=0.32;95%CI（0.19,0.55）;P<0.0001].Conclusion:When VHD patients accepted ER intervention,the length of postoperative hospital stay was shortened,the cardiopulmonary function was improved,and the incidence of postoperative adverse events was significantly reduced.In addition,ER might improve the quality of life in postoperative patients with VHD.Therefore,it is effective and safe for the application of ER in postoperative patients with VHD.