Transforming Early Phase I Post‑CABG Rehabilitation: Evidence, Technology Integration, and Future Directions
Keywords:
Early rehabilitation, Coronary artery bypass grafting (CABG), Augmented reality, Barthel Index, Cost-effectivenessAbstract
Coronary artery bypass grafting (CABG), while life-saving, initiates significant postoperative deconditioning. Historically, cardiac rehabilitation (CR) has focused on later phases, neglecting the critical early postoperative period. This review evaluates the safety, efficacy, and future direction of early Phase I CR, initiated within 72 hours post-CABG. Drawing from randomized controlled trials, meta-analyses, and nationwide cohort studies, this review synthesizes evidence supporting early rehabilitation’s clinical benefits. Functional outcomes (e.g., Barthel Index, 6-minute walk distance) and health system efficiencies (e.g., reduced ICU stay, cost savings) are analyzed alongside technology-enhanced strategies such as augmented reality (AR), virtual reality (VR), and digital twin modeling. Early Phase I CR demonstrates improved functional recovery (+54 m in 6MWD), reduced hospital/ICU stays, and no increase in adverse events. Technological adjuncts improve patient engagement, safety monitoring, and adherence. Economic analyses report substantial cost-effectiveness, with ICERs ranging from $2,000 to $28,000 per life-year gained. Limitations include variability in protocols, resource disparities, and lack of long-term survival data. Early Phase I CR post-CABG is clinically safe, functionally effective, and economically advantageous. Integration of AR/VR and digital tools promises further personalization and scalability. Future research should focus on long-term outcomes, protocol standardization, and equitable implementation across diverse populations.
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