Structured Inpatient Physiotherapy in High-Risk Coronary Artery Bypass Grafting Patients

Coronary artery bypass grafting (CABG) may be associated with prolonged recovery, particularly in high-risk patients. Although preoperative rehabilitation has shown promising results, evidence remains limited because of heterogeneous intervention protocols and variations in postoperative care. This study aims to investigate the effects of a structured inpatient physiotherapy program initiated at least two days before surgery and continued postoperatively, compared with the same structured physiotherapy program provided only during the postoperative period, in high-risk CABG patients. The primary outcome is hospital length of stay. Secondary outcomes include intensive care unit length of stay, C-reactive protein, neutrophil-to-lymphocyte ratio, hemoglobin, dyspnea, and fatigue.

Inclusion Criteria: * Adults aged 18 years or older. * Scheduled to undergo elective coronary artery bypass grafting (CABG). * High-risk patients meeting at least three of the following criteria: Left ventricular ejection fraction (LVEF) \65 years. \- Able and willing to provide written informed consent. Exclusion Criteria: * Planned redo CABG surgery. * Severe neurological or orthopedic conditions limiting mobilization. * Severe cognitive impairment. * Hemodynamic instability. * Contraindications to mobilization or exercise. * Inability to complete at least two days of the preoperative physiotherapy program.