An examination of the effects of preoperative and postoperative cardiac rehabilitation in patients undergoing coronary artery bypass graft surgery

Investigation of the Effects of Preoperative and Postoperative Cardiac Rehabilitation in Patients Undergoing Coronary Artery Bypass Graft Surgery. Master's Thesis, Istanbul Atlas University Postgraduate Education Institute, Department of Physiotherapy and Rehabilitation, Istanbul. This study aims to compare the effects of a cardiac rehabilitation (CR) program applied in both the preoperative and postoperative periods with the effects of a CR program applied only in the postoperative period in patients undergoing coronary artery bypass graft (CABG) surgery. In this randomized controlled trial, the control group (n=15) received a postoperative cardiac rehabilitation program that commenced on postoperative day one, provided that the patients were hemodynamically stable after being transferred from the intensive care unit to the ward. This program continued until hospital discharge and lasted for at least five days, with an average of one week. The experimental group (n=15) received both a preoperative cardiac rehabilitation program, which began on the first day of admission to the surgical ward and continued until the day of surgery (at least five days, averaging one week), and the same postoperative program as the control group. Demographic and clinical data, pulmonary function, peak expiratory flow (PEF), functional capacity, mobility, peripheral muscle strength, pain levels, fear of movement (kinesiophobia), and quality of life were evaluated using a "Demographic and Clinical Data Form," spirometry, PEF meter, six-minute walk test (6MWT), 30-second sit-to-stand test (30sSTS), digital hand-held dynamometer, Visual Analog Scale (VAS), Tampa Scale for Kinesiophobia Hearth Version (TSK-H), and the SF-36 Quality of Life Questionnaire. All measurements were conducted at four time points: beginning and end of the preoperative period, and beginning and end of the postoperative period. Significant postoperative improvements in FEV₁, FVC, PEF, and peak cough flow (PCF) were observed in both groups; however, no statistically significant time x group interaction was found for these variables (p>0.05). In contrast, statistically significant time x group interactions were identified in the experimental group in favor of greater improvements in 6MWT distance, 30sSTS score, quadriceps and biceps muscle strength, VAS pain scores, TSK scores, and the physical function subscale of SF-36 (p<0.05). These findings indicate that preoperative cardiac rehabilitation not only mitigates the negative effects of surgery but also contributes to the improvement of physical and psychological well-being. Therefore, integration of preoperative rehabilitation into routine clinical practice is recommended for patients scheduled to undergo CABG surgery.