The 21st century cardiac surgery patients have brought up new challenges related to post-op rehabilitation. The patients we operate on nowadays are older, frailer and their basic activity pre-op is limited. The importance of post-op rehabilitation cannot be over rated for open heart surgical patients and is related to both reduced morbidity and mortality.
Robot-assisted devices are becoming a popular alternative to manual facilitation in different post-op disciplines rehabilitation. These devices have the potential to reduce therapist burden and treatment costs and be as efficient if not more as the common rehabilitation.
Robot-assisted gait training (RAGT) the assistance provided by the robot is intended to serve as an analog to manual assistance provided by therapists. However, most of the robotic-assisted devices discussed in the literature are designed to provide constant guiding forces and do not mimic the variable assistance that a human therapist applies. RAGT devices currently come in 2 distinct forms: 1) exoskeletons - attach in parallel to the lower limb segments and move in unison with the patient, These devices are typically mounted over treadmills and include some form of body weight support. 2) RAGT devices that use movable footplates to which the patient’s feet are attached and the body weight baring is adjusted according to the patient ability.
RAGT was used as a facilitated rehabilitation tool for post-op cardiac patients that were identified as frail pre-op in our department.
These patients used the RAGT several times while hospitalized using an effort scale and were assisted by a therapist. During the activity hemodynamically parameters were observed and the weight lifting ability of the patient was adjusted between treatments. RAGT was used safely with no adverse events nor any impact on chest stability, it`s impact on morbidity and mortality is still under evaluation.
In this pilot study we demonstrate the feasibility of using RAGT for open heart surgical patients facilitated rehabilitation.
