Effects of early rehabilitation on functional outcomes in patients after coronary artery bypass graft surgery: a randomized controlled trial

Abstract

Objective This study evaluated the effectiveness, feasibility, and safety of early rehabilitation for patients after coronary artery bypass graft (CABG) surgery. Methods In a three-arm randomized controlled trial, patients who underwent CABG from January 2018 to June 2018 were randomly assigned to one of three groups: (i) usual care (UC group); (ii) UC + single general ward rehabilitation (SGR group); and (iii) UC + general ward rehabilitation and intensive care unit (ICU) rehabilitation (IGR group). The primary outcome was the Barthel Index scores. Results The Barthel Index score for UC (75.3 ± 12.1) was significantly lower than that of both SGR (86.2 ± 14.1) and IGR (89.1 ± 15.5). There was no significant difference in the Barthel Index scores between the SGR and IGR groups. Statistically significant differences were found in the length of ICU stay and post-operative hospital stay but not in post-operative pulmonary complications (PPC) or atrial fibrillation between the three groups. Conclusion Early rehabilitation implemented during ICU stay and on the general ward resulted in significant improvements in functional independence and could be a safe part of routine care post-CABG.

Outcomes of Genetic Testing-Based Cardiac Rehabilitation Program in Patients with Acute Myocardial Infarction after Percutaneous Coronary Intervention

“…The exclusion criteria were as follows: (1) exercise-induced syncope or ventricular arrhythmias; (2) inability to exercise and walk owing to comorbidities; (3) suffering from end-stage diseases such as malignancies; (4) severe complications such as pulmonary edema, severe arrhythmia, or cardiogenic shock; and (5) suffering from mental illness or family history of mental illness. All percutaneous coronary interventions were performed by the same team [ 17 ]. A total of 122 patients who underwent PCI after acute myocardial infarction were enrolled in the study.…”

Impact of Early Mobilization Within the Intensive Care Unit After Coronary Artery Bypass Grafting: A Systematic Review

“…The 14 included studies involved 2280 participants from 7 countries. Eleven studies were randomized controlled trials (RCT), [16][17][18][19][20][21][22][23][24][25][26] 2 were quasiexperimental, 27,28 and one was a cross-sectional study. 29 Fourteen of the studies demonstrated a moderate level of evidence when scored by the OCEBM, and one demonstrated a weak level of evidence because of a small sample size and lack of blinding (Table 3).…”

“…For this systematic review, 11 studies had a 1b level of evidence, [16][17][18][19][20][21][22][23][24][25][26] one study had a 2b level of evidence, 29 and 2 studies had a 2c level of evidence 27,28 based on an assessment using the OCEBM tool (Table 3). The studies were scored as moderate to high quality when rated with the PEDro scale, and there were no studies with a rating lower than a 2c using the OCEBM tool.…”

“…Eleven of the 14 articles within the evidence table were RCTs, [16][17][18][19][20][21][22][23][24][25][26] including 2 prospective studies. Three of the 11 RCT studies were single-blinded, 17,22,23 whereas the remaining 8 RCTs encountered limitations with blinding their participants and/or health care provider(s).…”

“…A risk of selection bias was determined to be present because of gender prevalence of male participants. Of the 14 studies, [16][17][18][19][20][21][22][23][24][25][26][27][28][29] 11 focused on only CABG procedures and 13 had predominantly male participants. One study focusing on participants requiring more than 72 hours of mechanical ventilation was predominantly women, with 64 women of the total 106.…”