Impact of an early, graduated mobilization program on recovery and postoperative outcomes after cardiac revascularization with extracorporeal circulation.

OBJECTIVE

This randomized controlled trial evaluated the effects of an early, graduated mobilization program on functional recovery (primary endpoint: postoperative day-5 forced vital capacity [FVC]; secondary endpoints: activities of daily living [ADL] scores, handgrip strength, Short Physical Performance Battery [SPPB] scores, postoperative pulmonary complications [PPCs], and postoperative length of stay) in patients undergoing on-pump coronary artery bypass grafting (CABG).

METHODS

Between March to September 2025, 92 patients underwent on-pump CABG; after screening, 80 consecutive eligible patients (sample size calculated based on PPC incidence, n = 42 per group before attrition adjustment) were randomized 1:1 using a random number table with allocation concealment to a control group (n = 40) or an intervention group (n = 40).

RESULTS

On postoperative day 5, the intervention group demonstrated significantly better FVC, ADL scores, handgrip strength, and SPPB scores (all P < 0.05). PPC incidence was markedly lower (10% vs. 62.5%, P < 0.0001), and postoperative length of stay was shorter (7.13 ± 2.36 vs. 9.18 ± 2.66 days, P = 0.0006).

CONCLUSION

The early graduated mobilization program was safe, feasible, and associated with improved short-term functional recovery, reduced PPCs, and shorter postoperative hospital stay after on-pump CABG. Larger multicenter studies with longer follow-up are required to confirm long-term safety and effectiveness.