Effects of pre-rehabilitation program among in-hospital patients undergoing elective coronary artery bypass grafting: study protocol for a single-centric, randomized, controlled trial

Abstract

Abstract Background: Coronary heart disease is considered an epidemic problem with the increasing number of people affected. Coronary artery bypass grafting (CABG) has been the gold standard treatment for revascularization in complex multivessel coronary artery disease. The pre-rehabilitation of CABG aims to improve the functional capacity of patients in the preoperative stage, optimize the physiological reserve to withstand the stress of surgery, and improve the functional status of patients after surgery. Since there are still relatively few studies on preoperative pre-rehabilitation with elective CABG, the main goal of this study is to evaluate whether pre-rehabilitation programs during phase I in-hospital rehabilitation can improve exercise tolerance among patients who undergo elective CABG. Furthermore, this study aims to investigate the effects of pre-rehabilitation program during phase I in-hospital rehabilitation on the inspiratory muscle strength, cardiac function, the conditions of anxiety and depression, health-related quality of life, the rate of pulmonary complication after CABG and the length of inpatient stay. Methods: This study will be a prospective, single-centre, two parallel groups, randomized controlled clinical trial with blinded evaluators. There are 4 measurement time points: T0= admission, T1 = 1 day before surgery, T2 = 1 day before discharge, T3 = 12- week follow-up. A total of 84 patients who will undergo elective CABG will be included. Interventions include oral education and preoperative pre-rehabilitation delivered by physiotherapists. The primary outcome is exercise tolerance measured by 6minute walking test. Secondary outcomes include inspiratory muscle strength, cardiac function, the conditions of anxiety and depression, health-related quality of life, exercise load, the rate of pulmonary complication after CABG and the length of inpatient stay. Final data collection is expected to be completed by May 2024. Discussion: This study may provide valuable insights into the effectiveness and safety of preoperative pre-rehabilitation for CABG to improve functional recovery after surgery and provide evidence for standardized preoperative pre-rehabilitation guidelines for CABG. Trial registration: The trial has been registered with the Chinese Clinical Trial Registry on March 6, 2023 under the registration number: ChiCTR2300069045