Cardiac Rehabilitation in Coronary Artery Bypass Graft Surgery

The Effects of Preoperative and Postoperative Cardiac Rehabilitation in Patients Undergoing Coronary Artery Bypass Graft Surgery

This randomized controlled trial investigates the comparative effects of a combined preoperative and postoperative cardiac rehabilitation program versus a postoperative-only program on functional capacity, pulmonary function, peripheral muscle strength, pain, kinesiophobia, and quality of life in patients undergoing coronary artery bypass graft (CABG) surgery. The study aims to determine whether initiating rehabilitation prior to surgery improves short-term postoperative outcomes.

Study Overview

• Status: Completed
• Conditions: Coronary Artery Disease; Coronary Artery Bypass Graft Surgery
• Intervention / Treatment: Other: Preoperative Cardiac Rehabilitation; Other: Postoperative Cardiac Rehabilitation

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Istanbul, Turkey (Türkiye)
    • İstanbul atlas university

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Having undergone coronary artery bypass graft surgery
• Ejection Fraction (EF) > 40%
• Being between the ages of 18-65
• Being able to speak, read and understand in their own language
• Volunteering to participate in the study

Exclusion Criteria:

• Having an active or suspected infection
• Presence of an active tumour
• History of thrombophlebitis or pulmonary embolism within the last 3 months
• Having an orthopaedic, neurological or cardiovascular disease that may affect the assessments

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental Group; Preoperative cardiac rehabilitation + postoperative cardiac rehabilitation (structured exercise, respiratory physiotherapy, and patient education)	Other: Preoperative Cardiac Rehabilitation; Structured exercise program, respiratory physiotherapy, and patient education; Other: Postoperative Cardiac Rehabilitation; Structured exercise program, respiratory physiotherapy, and patient education
Active Comparator: Control Group; Postoperative cardiac rehabilitation (structured exercise, respiratory physiotherapy, and patient education)	Other: Postoperative Cardiac Rehabilitation; Structured exercise program, respiratory physiotherapy, and patient education

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Forced Vital Capacity (FVC)	Forced Vital Capacity will be measured before six-minute walk test according to the guideline of ERS.	2 weeks
Forced Expiratory Volume in 1 second (FEV1)	Forced Expiratory Volume in 1 second will be measured before six-minute walk test according to the guideline of ERS.	2 weeks
Peak Expiratory Flow (PEF)	Peak Expiratory Flow will be measured before six-minute walk test according to the guideline of ERS.	2 weeks
Forced Expiratory Flow 25-75% (FEF25-75)	Forced Expiratory Flow 25-75% will be measured before six-minute walk test according to the guideline of ERS.	2 weeks
6-minute Walk Test	The 6-minute Walk Test will be performed according to ATS guidelines. Walking distance, minute ventilation, respiratory rate, inspiratory capacity and breathing reserve will be recorded.	2 weeks
M. Quadriceps Muscle Strength	The m. quadriceps muscle strength will be measured using the MicroFet 2 hand-held dynamometer (Hogan Health Industries, USA). The test will be repeated three times for the dominant side and the average value in kilograms (kg) will be recorded.	2 weeks
M. Biceps Muscle Strength	The m. biceps muscle strength will be measured using the MicroFet 2 hand-held dynamometer (Hogan Health Industries, USA). The test will be repeated three times for the dominant side and the average value in kilograms (kg) will be recorded.	2 weeks
Cough Peak Flow	Cough Peak Flow (CPF) will be measured using a peak expiratory flow meter. Participants will be instructed to take a maximal deep breath and then cough as forcefully as possible into the device; the highest value from three trials will be recorded in liters per minute (L/min). Measurements will be performed in a seated position, ensuring a tight mouth seal and consistent technique.	2 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Level of Pain	Pain assessment will be performed using the Visual Analog Scale (VAS) to evaluate chest pain levels. Participants will be asked to mark their current pain intensity on a 10 cm horizontal line, with "no pain" at one end and "worst imaginable pain" at the other. The distance in centimeters from the "no pain" end to the mark will be measured and recorded as the pain score.	2 weeks
Level of Fear of Movement	Fear of movement (kinesiophobia) will be assessed using the Tampa Scale for Kinesiophobia (TSK). Participants will complete the 17-item questionnaire, which evaluates fear of movement and re-injury on a 4-point Likert scale. The total score, ranging from 17 to 68, will be calculated, with higher scores indicating greater fear of movement.	2 weeks
Level of Quality of Life	Quality of life will be assessed using the Short Form-36 (SF-36) Health Survey. Participants will complete the 36-item questionnaire, which evaluates eight domains including physical functioning, bodily pain, general health, and mental well-being. Each domain will be scored from 0 to 100, with higher scores indicating better perceived quality of life.	2 weeks

Collaborators and Investigators

• Sponsor: Atlas University
• Investigators: Principal Investigator: Hikmet Ucgun, PT, PhD, Atlas University

Study record dates

Study Major Dates

• Study Start (Actual): August 1, 2024
• Primary Completion (Actual): August 1, 2025
• Study Completion (Actual): August 1, 2025

Study Registration Dates

• First Submitted: May 28, 2025
• First Submitted That Met QC Criteria: May 28, 2025
• First Posted (Actual): June 5, 2025

Study Record Updates

• Last Update Posted (Estimated): August 27, 2025
• Last Update Submitted That Met QC Criteria: August 21, 2025
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Keywords: Coronary Artery Disease; Coronary Artery Bypass Graft Surgery; Preoperative Cardiac Rehabilitation; Postoperative Cardiac Rehabilitation
• Additional Relevant MeSH Terms: Vascular Diseases; Cardiovascular Diseases; Heart Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Coronary Disease; Myocardial Ischemia; Coronary Artery Disease
• Other Study ID Numbers: auhucgun04

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No