Heart & lung : the journal of critical care · 2026
Best evidence summary for exercise adherence management in outpatient rehabilitation following coronary artery bypass graft surgery.
СтатьяОбзорПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Xiu Meng, Wang Hang, Zhang Meijie, Yang Fei, Wang Chenwei, Zhang Weiying
Аннотация
BACKGROUND: Coronary artery bypass grafting (CABG) is a common procedure for treating coronary artery disease. Exercise rehabilitation is essential for secondary prevention, but patient adherence remains low. High-quality evidence is needed to guide effective adherence management strategies.
OBJECTIVE: To evaluate and summarize the existing evidence on adherence management in phase II exercise rehabilitation following CABG, providing a foundation for the development of evidence-based clinical practice.
METHODS: Following the 6S pyramid model, a comprehensive top-down search was conducted to retrieve evidence related to adherence management in phase II exercise rehabilitation following CABG. The literature types included clinical decisions, guidelines, expert consensus, systematic reviews, evidence summaries, and the latest randomized controlled trials. The search period ranged from July 2015 to July 2025. Two researchers trained in evidence-based nursing graded the evidence according to the Joanna Briggs Institute evidence pre-classification and evidence recommendation level system (2014 version).
RESULTS: A total of 19 high-quality studies were included, from which 26 pieces of evidence were summarized. These pieces of evidence covered five aspects: overall approach, exercise plan, patient education, feedback and supervision, and management of special populations. Key strategies consistently highlighted included establishing a multidisciplinary rehabilitation team and a structured follow-up pathway, delivering individualized and progressive exercise prescriptions, providing multimodal education to enhance patients' understanding and self-efficacy, and strengthening monitoring/feedback mechanisms to support sustained self-management. Collectively, these strategies may facilitate long-term exercise adherence during phase II rehabilitation and improve the continuity and safety of post-discharge care.
CONCLUSIONS: Evidence supports a comprehensive, integrated phase II exercise adherence-management approach for post-CABG patients, emphasizing multidisciplinary collaboration, individualized progressive exercise prescription, multimodal education, and monitoring/feedback to promote sustained self-management and adherence. Strategies should be adapted to local resources and vulnerable groups. Future research should validate these strategies in CABG-specific populations and evaluate implementation feasibility and cost-effectiveness using standardized adherence outcomes.
PROTOCOL REGISTRATION: http://ebn.nursing.fudan.edu.cn/registerResources, identifier ES20246232.
OBJECTIVE: To evaluate and summarize the existing evidence on adherence management in phase II exercise rehabilitation following CABG, providing a foundation for the development of evidence-based clinical practice.
METHODS: Following the 6S pyramid model, a comprehensive top-down search was conducted to retrieve evidence related to adherence management in phase II exercise rehabilitation following CABG. The literature types included clinical decisions, guidelines, expert consensus, systematic reviews, evidence summaries, and the latest randomized controlled trials. The search period ranged from July 2015 to July 2025. Two researchers trained in evidence-based nursing graded the evidence according to the Joanna Briggs Institute evidence pre-classification and evidence recommendation level system (2014 version).
RESULTS: A total of 19 high-quality studies were included, from which 26 pieces of evidence were summarized. These pieces of evidence covered five aspects: overall approach, exercise plan, patient education, feedback and supervision, and management of special populations. Key strategies consistently highlighted included establishing a multidisciplinary rehabilitation team and a structured follow-up pathway, delivering individualized and progressive exercise prescriptions, providing multimodal education to enhance patients' understanding and self-efficacy, and strengthening monitoring/feedback mechanisms to support sustained self-management. Collectively, these strategies may facilitate long-term exercise adherence during phase II rehabilitation and improve the continuity and safety of post-discharge care.
CONCLUSIONS: Evidence supports a comprehensive, integrated phase II exercise adherence-management approach for post-CABG patients, emphasizing multidisciplinary collaboration, individualized progressive exercise prescription, multimodal education, and monitoring/feedback to promote sustained self-management and adherence. Strategies should be adapted to local resources and vulnerable groups. Future research should validate these strategies in CABG-specific populations and evaluate implementation feasibility and cost-effectiveness using standardized adherence outcomes.
PROTOCOL REGISTRATION: http://ebn.nursing.fudan.edu.cn/registerResources, identifier ES20246232.