Keywords

CABG, coronary artery bypass graft, prehabilitation, physical activity, physiotherapy, physical therapy, preoperative, presurgical

Abstract

Background and Purpose: Globally, coronary artery disease (CAD) affects 126.5 million adults. To decrease mortality, coronary artery bypass graft (CABG) surgeries are often performed. CABGs have inherent risks such as financial burden, physical complication, and emotional stress. Cardiac rehabilitation programs help decrease complications postoperatively. However, few interventions are performed preoperatively. Prehabilitation (prehab) programs have been created to address this gap in other types of surgeries. Prehab is the purposeful implementation of physical activity before a procedure to improve perioperative outcomes. Prehab prior to CABG has not been well studied previously. Furthermore, it is unknown if families should support a sedentary or active lifestyle for CABG patients prior to surgery. Therefore, the purpose of this systematic review was to investigate the effects of preoperative physical activity on outcomes for CABG patients.

Methods: Following PRISMA guidelines, 635 articles were identified, screened, and assessed. Databases included: Embase, MEDLINE, CINAHL, Cochrane Library, and SportDISCUS. Articles were assessed using Kmet et al.’s criteria for both qualitative and quantitative studies. In total, 13 articles were included in the systematic review.

Results: Physical activity at least twenty-four hours prior to CABG decreases postoperative complications, hospital length of stay, atrial fibrillation occurrence, rehospitalization, and mortality rates. Physical activity prior to CABG can impact psychosocial wellbeing by improving anxiety, creating a broader support system, and increasing quality of life. Preoperative physical activity also has the potential to increase physical ability both preoperatively and postoperatively. Lastly, the literature suggests that prior physical activity increases enrollment in post CABG CR programs.

Conclusions and Implications: We recommend early implementation of physical activity in patients at risk for or diagnosed with CAD to improve outcomes in the event CABG becomes necessary. These outcomes suggest families should support CABG patients in being physically active through structured, such as prehab, and unstructured methods.