importance of walking after open heart surgery

Importance of Walking after Open Heart Surgery

After successful open heart surgery, it’s normal to consider whether it is safe to walk after open heart surgery. And after that, the second question comes to mind, what’s the importance of walking after open heart surgery? In this blog post, we aim to answer some of the questions people who have had or are planning to have open heart surgery have about walking and exercise.

What is the Best Exercise after Open Heart Surgery?

In the first few weeks after open heart surgery, the best exercises are aerobic ones like walking and cycling. But after a while, you can do exercises that build strength and flexibility and even strenuous exercises. But the exercise training shouldn’t start until the wound from surgery is fully healed.

Start your program with shorter sessions, like 10-15 minutes of slow walking, and work up to 30–40 minutes of brisk walking with 10-minute warm-up and 10-minute cool-down periods. Please talk to your physiotherapy doctor before starting any exercise plan.

Importance of Walking after Open Heart Surgery

Early independence in walking after open heart surgery is important for independence in daily life, treatment of heart disease, and preventing the disease from coming back. Cardiac rehabilitation (CR) is recommended to start as soon as possible after heart surgery, between 24 and 72 hours after the surgery.

Studies show that early CR works well to prevent delirium, improve exercise tolerance, and reduce complications after surgery. Also, the goal is for people to be able to walk on their own within 4–7 days after surgery. Continued exercise training, especially aerobic exercise like walking, effectively lowers the risk of going back to the hospital and getting a heart attack and improving the quality of life.

On the other hand, patients who have had heart surgery often have to stay still for a long time. Surgery and long periods of bed rest after it can cause the muscles and bones to break down quickly.

Studies show that more than half of people who had cardiothoracic surgery had physical problems and that 25.5% of people couldn’t walk on their own when they were sent home. Previous studies have looked at the ability to walk on your own after heart surgery as an essential skill to learn.

Walking Program after Open Heart Surgery

After doing open heart surgery, your physiotherapy doctor should start exercise within 24-48 hours. But as you heal from open heart surgery, walking is the best way to get exercise. Before starting strenuous activities like swimming or biking, you should talk to your physician or physiotherapy doctor. Here we have pointed out some precautions that you should remind in mind after your open heart surgery.

  • When you start walking daily, please choose a time that works for you and stick to it.
  • Walk on flat ground at a steady, rhythmic pace with your arms swinging by your sides. 
  • Wear shoes that are comfortable to walk in and clothes that are right for the weather.
  • Do walking exercise after a minimum of 1 and 1/2 to 2 hours of eating, and don’t walk outside when it’s too hot or cold. When the weather is terrible, you can walk inside a shopping mall or a health club with a treadmill or an indoor track.
  • If you feel exhausted, short of breath, or dizzy, stop and rest immediately. The next day, decrease the distance you walk.
  • If you have chest pain, feel sick or throw up, have a headache or pain in your jaws, teeth, arms, or ears, or any other symptom similar to your previous angina, call your doctor right away and don’t walk again until your doctor says it’s okay.
  • One month after surgery, most people should be able to walk at least 1 to 1.5 miles daily.
  • Studies have shown that people who work out at least 30 minutes a day, five days a week, stay healthier and have fewer problems. Also, they might live longer.

What are the Long-term Side Effects of Open Heart Surgery?

Open-heart surgery is done to fix a blocked coronary artery. All surgeries have some risks, and some things that could go wrong with coronary artery bypass surgery are:

  • Bleeding
  • Heart attack due to a blood clot after surgery
  • Infection
  • Long-term need for a breathing machine
  • Irregular heart rhythms (Arrhythmias)
  • Renal (Kidney) complications
  • Memory loss or trouble thinking clearly, which is temporary
  • Stroke
  • Death

If the surgery is done quickly, there is a higher chance of something going wrong.

Your overall health before surgery also affects how likely you are to have problems after coronary artery bypass surgery. Having one of the following health problems makes the chance of complications higher:

  • Blocked arteries in the legs
  • COPD (Chronic obstructive pulmonary disease)
  • Diabetes
  • Kidney disease

Most of the time, medicines are given before surgery to stop bleeding, control blood pressure, and prevent infection. This is done to lower the risk of problems. During surgery, if you have diabetes, you may be given medicine to keep your blood sugar in check.

What causes Shortness of Breath after Open Heart Surgery?

Even low-risk patients who have had open heart surgery often have postoperative dyspnea or shortness of breath. Cardiac surgeons and anesthesiologists are used to seeing patients with dyspnea in the first few days after surgery. However, in some cases, standard treatments may not work, and a pulmonologist may need to be consulted.

After open heart surgery, the most common cause of shortness of breath is atelectasis. Pleural effusion and pneumonia were the following most common causes. People who had trouble breathing because of pneumonia had to stay in the ICU longer. Taking these causes into account when making treatment plans for this group of patients could help reduce the length of stay, the number of people who get sick, and the number of people who die.

What Happens if you Lift too Much After Heart Surgery?

You should move carefully during your first few weeks at home. Because during surgery, your sternum (breast bone) was cut. Typically to grow back together, the bone takes a minimum of 6 – 8 weeks. If you move in the wrong way, this bone may not be united. If you lift something heavy and the bone breaks, the wires in your sternum could come loose, which would cause a lot of trouble.

It can be hard to get used to doing exercise, but it will help you get better faster. If you do arm exercises, only lift something that weighs at most 10 pounds. To strengthen your sternum, you should only lift half-pound or one-pound weights for the first eight weeks of your recovery period. Ten curls on each arm is a good way to start. Make sure to protect your sternum with a pillow or some safety harness.

What are the Sleeping Positions after Open Heart Surgery?

After open-heart surgery, one of the important things about home care like sleeping in your bed. Even though there aren’t many rules to sleep after open heart surgery, you shouldn’t sleep on your stomach. Instead, here are some ideas from experts:

Back-sleeping: When you sleep on your back, your head, neck, and spine stay in the right place, and don’t stress your chest.

Side-lying: You don’t have to sleep on your back all the time, and you can lie on your side with some pillows behind you to keep you up. If you are lying on your side, you shouldn’t sleep on your stomach.

Rolling to reposition: When you get out of bed, roll over to your side. Don’t try to sit straight, this is better for your body than pushing up with your arms right away.

Leg healing: If you had a CABG using a blood vessel in your leg, sleeping with your legs up on pillows at first will help prevent swelling, and not crossing your legs will keep your blood flowing well. If you were told to take off your elastic compression stockings before bed to prevent blood clots called “deep vein thrombosis,” you should do so.

Less napping: As you get stronger and feel better, limiting the number of naps or rests you take during the day can help you get a better night’s sleep.

Pillow support: If you tend to roll around in your sleep, you can use a bed wedge or regular pillows to help you stay comfortable.

If you have to go upstairs to get to your bedroom, that can be a problem. Depending on a patient’s age, level of activity, or weakness for the first few days, it may be best to use a downstairs bedroom if one is available or put a bed there. It’s important that they don’t fall going up or down the stairs.

What are the Restrictions after Open Heart Surgery?

During the first few days of walking or climbing stairs, you can ask for help. The best way to get exercise is to walk. And you are already aware of the importance of walking after open heart surgery. It should be done slowly, stopped, or limited if you have trouble breathing.

Don’t lift heavy weights or do any other exercise that hurts or strains your chest muscles. Don’t drive for six weeks after surgery because you must twist your body to turn the steering wheel. During the early stages of recovery, you should avoid long trips and limit your sexual activity. Over time, sexual activity can start again. Don’t take any drugs that make you more sexual.

Final Words

After bypass or valve surgery, it can take six to eight weeks to recover fully, but you may still feel pain at the chest incision site for a while longer. Independent walking is one of the most important things to do after open heart surgery to prevent a recurrence, keep exercising, and be able to live on your own. You should follow your surgeon, cardiologist, physiotherapist, or other healthcare provider’s instructions.


Resources

1. JCS Joint Working Group Guidelines for Rehabilitation in Patients With Cardiovascular Disease (JCS 2012) Circ. J. 2014;78:2022–2093. doi: 10.1253/circj.CJ-66-0094. [PubMed] [CrossRef] [Google Scholar]
2. Dong Z., Yu B., Zhang Q., Pei H., Xing J., Fang W., Sun Y., Song Z. Early Rehabilitation Therapy Is Beneficial for Patients With Prolonged Mechanical Ventilation After Coronary Artery Bypass Surgery. Int. Heart J. 2016;57:241–246. doi: 10.1536/ihj.15-316. [PubMed] [CrossRef] [Google Scholar]
3. Balady G.J., Ades P.A., Bittner V.A., Franklin B.A., Gordon N.F., Thomas R.J., Tomaselli G.F., Yancy C.W. Referral, enrollment, and delivery of cardiac rehabilitation/secondary prevention programs at clinical centers and beyond: A presidential advisory from the American Heart Association. Circulation. 2011;124:2951–2960. doi: 10.1161/CIR.0b013e31823b21e2. [PubMed] [CrossRef] [Google Scholar]
4. Franklin B.A., Brinks J., Sacks R., Trivax J., Friedman H. Reduced walking speed and distance as harbingers of the approaching grim reaper. Am. J. Cardiol. 2015;116:313–317. doi: 10.1016/j.amjcard.2015.04.024. [PubMed] [CrossRef] [Google Scholar]
5. Clinical & Experimental Cardiology
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MAHMUDUL HASAN

"Hasan", I am a physiotherapy Doctor. I have completed my B.S.c course (4 years) under Rajshahi University, Faculty of Medicine, Rajshahi. Currently I am working as a clinical physiotherapist at a renowned physiotherapy center and I am continuing my MPT (Master's of physiotherapy) degree at CRP, Savar.

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