Structured interval training for early mobilization versus standard care after cardiac surgery: effects on mobility and physical function—a randomized controlled trial
Rehabilitation for patient following cardiac surgery.
Standard Care (Control Group): Preoperative physiotherapy care will be initiated through education, similar to standard care with an added interval structured for early ambulation protocol based on Boden et al. (2018). This includes instructions on safe movement using the Move in the Tube (MinT) method and the importance of early movement after surgery. After surgery, once the patient is medically stable, the physiotherapist will repeat this education. Patients will also be assessed to identify their risk of developing lung complications after surgery. It will be provided as soon as practical after surgery by a physiotherapist. Patients will receive one supervised ambulation session per day until a threshold score is met or discharge from hospital, whichever occurs first. After the breathing tube is removed, patients will start simple exercises. These include arm, foot, and ankle movements, as well as gradual walking. The physiotherapist will guide patients to continue using the MinT method and to increase their activity step by step until discharge. The key difference from the intervention group is that there is no fixed or structured plan for how long the exercises or walking sessions should be. Intervention Group: Before surgery, patients will receive the same physiotherapy education as the standard care group. In addition, they will follow a structured walking (ambulation) program. After surgery, this program will begin as soon as it is safe. A physiotherapist will supervise one walking session per day until the patient reaches the target level or is discharged. At every session, the participant will be progressed sequentially through the protocol stages. The daily aim for the participant is to achieve stage 6 or greater, aiming to achieve a walking time of at least 10 min, but no more than 15 min, at an intensity of at least three on the Borg 10-point visual analogue scale (VAS) of perceived exertion and where breathing is deeper than at rest. The treatin
1. Elective cardiac surgical procedure, involving a median sternotomy 2. Able to provide informed consent 3. Adults over the age of 18 years
1. Insufficient Malay/English comprehension to provide informed consent 2. Unable to complete simple, written questionnaires, and/or understand simple, verbal instructions 3. Unable to perform physical assessment/6 min walk test 4. Unwilling to participate in the study