The Effects of Cardiopulmonary Pre-Rehabilitation on Physical Performance, Balance, and Fear of Falling Among the Candidates for Coronary Artery Bypass Graft Surgery.

Introduction: Patients awaiting heart surgery often experience reduced physical activity, leading to decreased muscle mass, strength, and endurance. Objectives: This study aimed to evaluate the effects of cardiopulmonary pre-rehabilitation (CPPR) on physical performance, balance, and fear of falling (FOF) in candidates for coronary artery bypass graft (CABG) surgery. Methods: This randomized clinical trial was conducted in 2022. Ninety-two candidates for CABG surgery were recruited and randomly allocated to two 46-person groups using block randomization with a block size of 4. Participants in the intervention group received a 1-month CPPR program consisting of Otago exercise, incentive spirometry, walking, and modification of lifestyle and cardiovascular risk factors. Physical performance, balance, and FOF were assessed before and after the intervention and 4 weeks after surgery. Data collection instruments were a demographic and clinical characteristics questionnaire, the Short Physical Performance Battery, Berg Balance Scale, and Falls Efficacy Scale-International. The validity and reliability of these instruments have been established in previous literature and were also confirmed in the present study (Cronbach's alpha > 0.85 for all). Results: No significant differences were observed between the groups at baseline regarding the mean scores of physical performance, balance, and FOF (p > 0.05). Following the intervention, the CPPR group demonstrated significantly greater improvements in physical performance (p < 0.001) and balance (p < 0.001), and a significantly greater reduction in FOF (p < 0.001) compared to the control group. These significant between-group differences were maintained at the 4-week postoperative assessment. Conclusion: This study concludes that CPPR is effective in significantly improving physical performance and balance and significantly reducing FOF among the candidates for CABG surgery. Therefore, it can be used to prepare the candidates for CABG surgery and improve postoperative outcomes.