Early Mobilization Following Cardiac Surgery: A Systematic Review of Functional and Hospital Outcomes.

BACKGROUND

Early mobilization (EM) has become essential for improved recovery after surgery, but its particular advantages in cardiac surgery populations have not been consistently reported.

OBJECTIVE

To systematically evaluate the effects of early mobilization on functional recovery outcomes, hospital length of stay, and safety profiles in patients undergoing cardiac surgery.

METHODS

The systematic search was performed in six databases (PubMed, Google Scholar, Cochrane CENTRAL, PEDro, Embase, and Web of Science). The search included studies published between January 1, 2015, and August 2025. Inclusion criteria were that the studies must look at interventions of early mobilization (within 48 h of postoperative) in patients undergoing cardiac surgery, and the outcome measures may include functional capacity, length of stay in the hospital, or precautionary measures. Risk of Bias 2.0 (RoB 2) and Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I) were used to evaluate the risk of bias.

RESULTS

This review included 20 studies with 11,631 participants, 12 randomized controlled trials, four observational cohort studies, and four other study types. Most interventions were initiated within 24 h after the operation. Functional recovery outcomes were predominantly favorable. Early mobilization improved 6-Minute Walk Test (6MWT) distance and functional independence scores in the majority of studies, whereas hospital length of stay results were inconsistent, with approximately half of the studies reporting significant reductions. The safety profiles were excellent throughout the studies, and few serious adverse events could be directly related to early mobilization. Subgroup analyses showed that Coronary Artery Bypass Grafting (CABG) had specific advantages, which were possible even in frail older patients.

CONCLUSIONS

Early mobilization following cardiac surgery appears safe and is associated with improvements in functional recovery (e.g., walking capacity and independence) and selected hospital outcomes (e.g., length of stay), although the magnitude of benefit varies across studies.

TRIAL REGISTRATION: PROSPERO (CRD420251140353).