The goal of this clinical trial is to learn if a structured early exercise program can help patients recover better in people who have just had coronary artery bypass surgery. The main questions it aims to answer are: * Does this early exercise improve fitness and walking ability? * Does it reduce the risk of muscle weakness (sarcopenia) after surgery? * Does it improve patients' quality of life? * Does it reduce feelings of anxiety and depression? Researchers will compare the group receiving the structured early exercise program (plus standard hospital care) to the group receiving standard hospital care only to see if the early exercise program leads to better and faster recovery. Participants in the exercise group will: * Start supervised exercise sessions within 24 hours after their surgery. * Perform these sessions twice a day for 30 minutes each, for 5 days. * The exercises include warm-ups, breathing exercises, walking or stationary cycling, and light resistance training.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
40
The training protocol was developed by integrating Phase 1 cardiac rehabilitation guidelines with an expert consensus approach from a multidisciplinary team. The intervention began within 24 hours postoperatively, was conducted for 5 days, twice daily, 30 min/session. Sessions included a 5-min warm-up (active/passive ROM), a 20-min main training (FITT principle: Intensity at resting heart rate + 20 bpm, max 120 bpm; Type: inspiratory muscle training, ROM, stationary cycling or bedside ambulation, resistance training), and a 5-min cool-down.
The standard hospital nursing care included physiological monitoring, medication counseling, psychological support, disease-specific health education, instruction on the use of an incentive spirometer, and education on the importance and methods of rehabilitation.
Far Eastern Medical Foundation Far Eastern Memorial Hospital
New Taipei City, Taiwan
Change in Cardiorespiratory Fitness
Assessed by the 6-minute walk test (6MWT). Total distance (in meters) walked along a 30-meter flat corridor in six minutes.
Time frame: Baseline (preoperative at admission), Postoperative Day 6, Postoperative Day 14
Change in Sarcopenia Risk Classification
Assessed using the Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls (SARC-F) questionnaire. The total score ranges from 0 to 10. Higher scores indicate a greater risk of sarcopenia (worse outcome). Classified as "at risk" (SARC-F total score more than or equal to 4 points) or "not at risk".
Time frame: Baseline (preoperative at admission), Postoperative Day 6, Postoperative Day 14
Change in Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls (SARC-F) Total Score
Assessed using the Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls (SARC-F) questionnaire. The total score ranges from 0 to 10. Higher scores indicate a greater risk of sarcopenia (worse outcome).
Time frame: Baseline (preoperative at admission), Postoperative Day 6, Postoperative Day 14
Change in Muscle Strength (Left Handgrip)
Assessed by maximal handgrip strength (in kg) using a hydraulic dynamometer.
Time frame: Baseline (preoperative at admission), Postoperative Day 6, Postoperative Day 14
Change in Muscle Strength (Right Handgrip)
Assessed by maximal handgrip strength (in kg) using a hydraulic dynamometer.
Time frame: Baseline (preoperative at admission), Postoperative Day 6, Postoperative Day 14
Change in Physical Performance (5-Times Sit-to-Stand Test)
Time (in seconds) taken to stand and sit five times from a chair with arms crossed.
Time frame: Baseline (preoperative at admission), Postoperative Day 6, Postoperative Day 14
Change in Muscle Mass Proxy (Left Calf Circumference)
Maximum circumference (in cm) at the widest part of the calf while seated.
Time frame: Baseline (preoperative at admission), Postoperative Day 6, Postoperative Day 14
Change in Muscle Mass Proxy (Right Calf Circumference)
Maximum circumference (in cm) at the widest part of the calf while seated.
Time frame: Baseline (preoperative at admission), Postoperative Day 6, Postoperative Day 14
Change in Quality of Life
Assessed using the EuroQol 5-Dimension 3-Level (EQ-5D-3L) questionnaire. The index score typically ranges from 0 to 1.00. Higher scores indicate a better quality of life (better outcome), with 1.00 representing perfect health and 0 representing death.
Time frame: Baseline (preoperative at admission), Postoperative Day 6, Postoperative Day 14
Change in Self-Rated Health
Assessed using the EuroQol visual analogue scale (EQ-VAS). Scale 0 (worst imaginable) to 100 (best imaginable).
Time frame: Baseline (preoperative at admission), Postoperative Day 6, Postoperative Day 14
Change in Mood (Anxiety)
Assessed using the Hospital Anxiety and Depression Scale (HADS) Anxiety subscale. Score ranges from 0 to 21. Higher scores indicate higher levels of anxiety (worse outcome).
Time frame: Baseline (preoperative at admission), Postoperative Day 6, Postoperative Day 14
Change in Mood (Depression)
Assessed using the Hospital Anxiety and Depression Scale (HADS) Depression subscale. Score ranges from 0 to 21. Higher scores indicate higher levels of depression (worse outcome).
Time frame: Baseline (preoperative at admission), Postoperative Day 6, Postoperative Day 14
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