Towards better recovery - optimizing rehabilitation care in cardiac surgery: the relevance of handgrip strength, physical activity, and quality of life
Towards better recovery after cardiac surgery
Cardiac surgery is a major life event, and the best possible recovery depends on more than a successful operation. This thesis of Sandra Dijkstra investigates how physical health before cardiac surgery, particularly handgrip strength, physical activity, and quality of life, can help improve rehabilitation and support more personalized care.
This research shows that patients with lower physical fitness are often more vulnerable and report lower quality of life before surgery. Handgrip strength emerged as a simple and reliable measure of muscle strength that is easy to use in clinical practice. Although handgrip strength and physical activity did not consistently predict complications after surgery, they were related to patients’ recovery and quality of life. The findings also demonstrate that subjective questionnaires and objective portable devices measure different but complementary aspects of the construct ‘physical activity’ and are best used simultaneous.
A key part of this thesis is the evaluation of the Heart-ROCQ programme, an innovative rehabilitation programme that starts before surgery, continues with a stay in the rehabilitation centre shortly after surgery, and is followed by further rehabilitation at the centre after returning home. The programme was found to be safe, feasible and well accepted, enabling patients to gradually rebuild their muscle strength and exercise capacity.
Overall, this thesis supports a more preventive and personalized approach to cardiac rehabilitation. Comprehensive assessments of physical health and tailored exercise programmes, may help to better identify patients’ needs and may improve recovery, long-term health, and quality of life after cardiac surgery.