CARDIOPULMONARY OUTCOMES FOLLOWING EARLY VS. DELAYED MOBILIZATION AFTER CARDIAC SURGERY
Pro4
DOI:
https://doi.org/10.71000/neh11535Keywords:
Cardiac Surgical Procedures, Early Ambulation, Hospital Stay, Pakistan, Postoperative Care, Pulmonary Function Tests, Randomized Controlled TrialAbstract
Background: Postoperative pulmonary complications remain a significant concern following cardiac surgery, often prolonging hospital stay and impairing recovery. Early mobilization has been suggested as a beneficial intervention; however, its comparative efficacy against delayed physiotherapy in the context of regional healthcare systems like Punjab, Pakistan, has not been fully explored.
Objective: To compare the effects of early versus delayed physiotherapy initiation on pulmonary function and length of hospital stay in patients undergoing elective cardiac surgery.
Methods: A 12-month, randomized controlled trial was conducted across three tertiary hospitals in Punjab. A total of 120 patients undergoing elective cardiac surgery were randomly assigned into two groups: early mobilization (within 24–48 hours post-surgery) and delayed mobilization (after 72 hours). Pulmonary outcomes were measured using spirometry (FVC, FEV₁, PEFR) on postoperative days 3 and 7. Hospital stay was recorded in days. Data were analyzed using independent t-tests with significance set at p<0.05.
Results: Patients in the early mobilization group demonstrated significantly higher pulmonary function on both day 3 and day 7 postoperatively (FVC: 2.7 ± 0.4 L vs. 2.3 ± 0.3 L; PEFR: 360 ± 42 L/min vs. 310 ± 37 L/min). The average hospital stay was also notably shorter (6.8 ± 1.1 days vs. 8.4 ± 1.3 days; p<0.05). No adverse events were reported in either group related to mobilization.
Conclusion: Early mobilization significantly enhances postoperative pulmonary recovery and reduces hospital stay in cardiac surgery patients. Integrating early physiotherapy into routine postoperative care in Punjab’s hospitals can optimize recovery outcomes and healthcare resource use.
References
González-Hadad A, Ordoñez CA, Parra MW, Caicedo Y, Padilla N, Millán M, et al. Damage control in penetrating cardiac trauma. Colomb Med (Cali). 2021;52(2):e4034519.
Awaludin S, Novitasari D. Determinants of Early Mobilization in Postcardiac Surgery Patients. Curr Probl Cardiol. 2024;49(1 Pt B):102110.
Ribeiro BC, Poça J, Rocha AMC, Cunha C, Cunha KDC, Falcão LFM, et al. Different physiotherapy protocols after coronary artery bypass graft surgery: A randomized controlled trial. Physiother Res Int. 2021;26(1):e1882.
Borges MGB, Borges DL, Ribeiro MO, Lima LSS, Macedo KCM, Nina V. Early Mobilization Prescription in Patients Undergoing Cardiac Surgery: Systematic Review. Braz J Cardiovasc Surg. 2022;37(2):227-38.
Long C, Duan X, Liu J, Xiang Z, Gao F, Zhang X, et al. Effect of a preoperative mobilization program on perioperative complications and function recovery in older adults with femoral neck fracture. Geriatric nursing. 2022;44:69-75.
Yau DKW, Ng FF, Wong MH, Underwood MJ, Wong RHL, Joynt GM, et al. Effect of exercise prehabilitation on quality of recovery after cardiac surgery: a single-centre randomised controlled trial. Br J Anaesth. 2025;134(1):45-53.
Shahood H, Pakai A, Rudolf K, Bory E, Szilagyi N, Sandor A, et al. The effect of preoperative chest physiotherapy on oxygenation and lung function in cardiac surgery patients: a randomized controlled study. Ann Saudi Med. 2022;42(1):8-16.
Sarwer A, Hussain A, Rafiq K, Latif S, Ayub Z, Yousaf B. THE EFFECT OF RESPIRATORY PHYSIOTHERAPY ON ATELECTASIS AND OXYGENATION IN POST-CARDIAC SURGERY PATIENTS. Biological and Clinical Sciences Research Journal. 2024.
Torres D, Paisani D, Reis H, Da Silva PS, Chiavegato L. Effectiveness of an early mobilization program on functional capacity after coronary artery bypass surgery: Randomized controlled trial. European Respiratory Journal. 2016;48.
Umar U, Hussain A, Tariq K. Effects of preoperative respiratory muscle training for improvement of postoperative health related quality of life in mitral valve replacement patients. Physiother Res Int. 2024;29(4):e2123.
Aquino TN, Prado JP, Crisafulli E, Clini EM, Galdino G. Efficacy of Respiratory Muscle Training in the Immediate Postoperative Period of Cardiac Surgery: A Systematic Review and Meta-Analysis. Braz J Cardiovasc Surg. 2024;39(1):e20220165.
Zhang R, Zhu C, Chen S, Tian F, Chen Y. Exercise-Based Cardiac Rehabilitation for Patients After Heart Valve Surgery: A Systematic Review and Re-Evaluation With Evidence Mapping Study. Clin Cardiol. 2025;48(3):e70117.
Cordeiro ALL, Barbosa HCM, Mascarenhas DSJ, Santos JCD, Guimarães ARF. Functional performance of patients submitted to cardiac surgery with different levels of sleep quality: an observational study. Braz J Otorhinolaryngol. 2024;90(6):101497.
Cordeiro A, De Sá JP, Lima ADS, Guimarães A, De Oliveira CM. Impact of early mobilization on clinical and functional outcomes in patients submitted to coronary artery bypass grafting. American journal of cardiovascular disease. 2022;12 2:67-72.
Doroshenko E, Kovalenko T, Hertsyk A, Gavreliuk S, Vitomskyi V, Lazarieva O, et al. The impact of mobilization protocols on the length of postoperative hospitalization among cardiac surgery patients. Zaporozhye Medical Journal. 2021.
Corovic M, Mosleh K, Puglisi O, Cameron M, Crawshaw J, Styra R, et al. JUMPSTART: evaluation of an early mobilization program following transcatheter aortic valve replacement. BMC Cardiovasc Disord. 2025;25(1):216.
Khan M, Bukhsh Nazir SN, Mirza Baig AA. Physiotherapy practices for patients undergoing coronary artery bypass grafting: A cross-sectional study. J Pak Med Assoc. 2021;71(1(b)):247-51.
Imura H, Murata T, Maruyama Y, Maeda M, Amitani R, Shirakawa M, et al. Postoperative Changes in Pulmonary Function after Valve Surgery: Oxygenation Index Early after Cardiopulmonary Is a Predictor of Postoperative Course. Journal of Clinical Medicine. 2021;10.
Zeng F, Luo J, Ye J, Huang H, Xi W. Postoperative Curative Effect of Cardiac Surgery Diagnosed by Compressed Sensing Algorithm-Based E-Health CT Image Information and Effect of Baduanjin Exercise on Cardiac Autonomic Nerve Function of Patients. Comput Math Methods Med. 2022;2022:4670003.
Cui Z, Li N, Gao C, Fan Y, Zhuang X, Liu J, et al. Precision implementation of early ambulation in elderly patients undergoing off-pump coronary artery bypass graft surgery: a randomized-controlled clinical trial. BMC Geriatr. 2020;20(1):404.
Takahashi T, Watanabe H, Mochizuki M, Kikuchi Y, Kitahara E, Yokoyama-Nishitani M, et al. Relationship between prehabilitation responsiveness and postoperative physical functional recovery in cardiovascular surgery. J Cardiol. 2024;84(6):366-71.
Pisano C, Polisano D, Balistreri CR, Altieri C, Nardi P, Bertoldo F, et al. Role of Cachexia and Fragility in the Patient Candidate for Cardiac Surgery. Nutrients. 2021;13(2).
Barker K, Rydberg L, Lanphere J, Malmut L, Neal J, Eickmeyer S. The utility of inpatient rehabilitation in heart transplantation: A review. Clin Transplant. 2024;38(1):e15182.
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Copyright (c) 2025 Abdul Aziz, Warda Khalid, Musawer Jawed, Iraj Fatima, Muhammad Faisal Qureshi, Muhammad Usman Gul, Iftikhar Ud Din (Author)
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