Effect of early cardiac rehabilitation therapy on patients after coronary artery bypass surgery: A three-armed randomized controlled trial

Abstract

Early cardiac rehabilitation (CR) including intensive care unit (ICU) and general ward is recommended for patients after coronary artery bypass surgery (CABG). This study examined the feasibility and practicality of early rehabilitation and tried to explored how important the rehabilitation in ICU. A three-armed randomized controlled trial exploring the importance of rehabilitation in ICU was conducted in patients after CABG. One hundred and twenty-three patients were randomly assigned to control group ( n = 40); single general ward rehabilitation group ( n = 42); or combined ICU with general ward rehabilitation group ( n = 41). The rehabilitation therapy consisted of 6 steps including moving on the bed, sitting on the edge of bed, standing, walking along a bed, walking in the room, and walking outside the room. Therapists who undertook patient assessments were blinded to treatment assignment. The primary outcome measure was a composite of postoperative complications, length of hospital stay, quality of life (QoL) scores and 6-min walk distance (6-MWD). The groups were well balanced in terms of patient characteristics. The intention-to-treat analysis of the study revealed that, compared with the control group, the combined group had a significant increase in 6-MWD (by 34.36 m, P = 0.002), global scores (by 3.6 d, P = 0.001); and a lower pulmonary postoperative severity (grade II–IV). With regard to length of hospital stay, both of the general group and combined group had no significantly difference comparing with the control group. Our results strongly support national standards that recommend early CR for patients after CABG. We also find that ICU rehabilitation is an integral part of the early CR process.