Effect of Early Rehabilitation Exercise on Lower Limb Function and Psychological State After Coronary Artery Bypass Grafting: A Randomized Controlled Trial

Hanxiang Ma, Shaojun Huang, Mei You, Jie Yang, Ruijie Zong, Chengxin Zhang
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Abstract

Background: While early rehabilitation exercise has been shown to improve cardiopulmonary function and functional outcomes after revascularization in individuals who have undergone coronary artery bypass grafting (CABG), further research is still needed to fully understand the importance of psychological status and limb functional rehabilitation following CABG. Therefore, the purpose of this study was to investigate the effects of early rehabilitation exercise on lower limb function and mental health after coronary artery bypass grafting. Methods: Eighty patients who underwent CABG were randomly divided into a routine exercise group and an early rehabilitation exercise group. The degree of lower limb swelling, the amount of incision complications, the first time the patient got out of bed after the operation, the length of postoperative hospital stay, activity tolerance and postoperative psychological state were compared between the two groups. Results: The incidence of postoperative lower extremity oedema was 30% in the early rehabilitative exercise group as compared to 52.5% in the routine exercise group. Between the two groups, there was a statistically significant difference (p < 0.05) in the incidence of postoperative lower limb edema as well as the amount of swelling in the thighs and ankles on postoperative days 1, 3, and 5. In the routine exercise group, the first time the patients got out of bed was 3.45 ± 1.09 days, and the length of postoperative hospitalization was 12.75 ± 5.06 days. In the early rehabilitation exercise group, the first time the patients got out of bed was 1.93 ± 0.57 days, and the length of postoperative hospitalization was 9.50 ± 2.92 days. There were statistically significant differences in these two indices between the two groups (p < 0.05). The activity tolerance of patients in the routine exercise group was 46.10 ± 19.09 min at 2 months after surgery and 69.88 ± 19.05 min at 3 months after surgery. The activity tolerance of patients in the early rehabilitation exercise group was 56.40 ± 17.42 min at 2 months after surgery and 105 ± 23.04 min at 3 months after surgery, and there was a significant difference in activity tolerance between the two groups at these time points following surgery (p < 0.05). In addition, there were statistically significant differences in the Patient Health Questionnaire-9, Generalized Anxiety Self-Assessment Scale-7 and Pittsburgh Sleep Quality Index scores between the two groups (p > 0.05). Conclusions: Early rehabilitation exercises can promote the recovery of lower limb function after CABG to a certain extent, shorten the postoperative bed rest time and hospital stay, and effectively improve postoperative psychological well-being and sleep quality.
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早期康复锻炼对冠状动脉旁路移植术后下肢功能和心理状态的影响:随机对照试验
背景:已有研究表明,早期康复锻炼可改善接受冠状动脉旁路移植术(CABG)的患者血管再通后的心肺功能和功能预后,但要充分了解冠状动脉旁路移植术后心理状态和肢体功能康复的重要性,仍需进一步研究。因此,本研究旨在探讨冠状动脉旁路移植术后早期康复锻炼对下肢功能和心理健康的影响。研究方法将 80 名接受冠状动脉旁路移植术的患者随机分为常规锻炼组和早期康复锻炼组。比较两组患者的下肢肿胀程度、切口并发症数量、术后首次下床活动时间、术后住院时间、活动耐受力和术后心理状态。结果早期康复锻炼组术后下肢水肿发生率为 30%,而常规锻炼组为 52.5%。两组患者术后下肢水肿的发生率以及术后第 1、3 和 5 天大腿和脚踝的肿胀程度差异有统计学意义(P < 0.05)。常规锻炼组患者首次下床活动时间为(3.45±1.09)天,术后住院时间为(12.75±5.06)天。早期康复锻炼组患者首次下床活动时间为(1.93±0.57)天,术后住院时间为(9.50±2.92)天。两组患者的这两项指标差异有统计学意义(P < 0.05)。常规运动组患者术后 2 个月的活动耐量为(46.10 ± 19.09)分钟,术后 3 个月的活动耐量为(69.88 ± 19.05)分钟。早期康复锻炼组患者术后 2 个月时的活动耐量为(56.40 ± 17.42)分钟,术后 3 个月时的活动耐量为(105 ± 23.04)分钟,两组患者在术后上述时间点的活动耐量存在显著差异(P < 0.05)。此外,两组患者在患者健康问卷-9、广泛焦虑自评量表-7 和匹兹堡睡眠质量指数评分方面的差异也有统计学意义(P > 0.05)。结论早期康复锻炼能在一定程度上促进 CABG 术后下肢功能的恢复,缩短术后卧床时间和住院时间,有效改善术后心理状态和睡眠质量。
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