Structured Inpatient Physiotherapy in High-Risk Coronary Artery Bypass Grafting Patients
Effect of a Preoperatively Initiated Structured Inpatient Physiotherapy Program on Postoperative Outcomes in High-Risk Coronary Artery Bypass Grafting Patients
Bezmialem Vakif University
100 participants
Jul 22, 2026
INTERVENTIONAL
Conditions
Summary
Coronary artery bypass grafting (CABG) may be associated with prolonged recovery, particularly in high-risk patients. Although preoperative rehabilitation has shown promising results, evidence remains limited because of heterogeneous intervention protocols and variations in postoperative care. This study aims to investigate the effects of a structured inpatient physiotherapy program initiated at least two days before surgery and continued postoperatively, compared with the same structured physiotherapy program provided only during the postoperative period, in high-risk CABG patients. The primary outcome is hospital length of stay. Secondary outcomes include intensive care unit length of stay, C-reactive protein, neutrophil-to-lymphocyte ratio, hemoglobin, dyspnea, and fatigue.
Eligibility
Inclusion Criteria5
- Adults aged 18 years or older.
- Scheduled to undergo elective coronary artery bypass grafting (CABG).
- High-risk patients meeting at least three of the following criteria:
- Left ventricular ejection fraction (LVEF) <40%. Three-vessel coronary artery disease. More than two comorbidities. History of smoking. Age >65 years.
- \- Able and willing to provide written informed consent.
Exclusion Criteria6
- Planned redo CABG surgery.
- Severe neurological or orthopedic conditions limiting mobilization.
- Severe cognitive impairment.
- Hemodynamic instability.
- Contraindications to mobilization or exercise.
- Inability to complete at least two days of the preoperative physiotherapy program.
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Interventions
Participants will receive a structured inpatient physiotherapy program initiated at least two days before CABG surgery and continued throughout postoperative hospitalization. The program includes breathing exercises, incentive spirometry, bronchial hygiene techniques, progressive early mobilization, and postural exercises. Before surgery, one supervised session will be provided daily, and participants will be instructed to repeat the program independently twice daily.
Participants will receive the same structured inpatient physiotherapy program only during the postoperative hospitalization. The program includes breathing exercises, incentive spirometry, bronchial hygiene techniques, progressive early mobilization, and postural exercises.
Locations(1)
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NCT07725887