The THE EFFECT OF PHASE II CARDIAC REHABILITATION EXERCISE ON FUNCTIONAL CAPACITY IN PATIENTS AFTER CORONARY ARTERY BYPASS SURGERY (CABG)
PENGARUH LATIHAN REHABILITASI JANTUNG FASE II TERHADAP KAPASITAS FUNGSIONAL PADA PASIEN PASCA BEDAH PINTAS ARTERI KORONER
Keywords:
CABG, kapasitas fungsional, rehabilitasi jantungAbstract
Coronary heart disease often requires Coronary Artery Bypass Grafting (CABG). Postoperatively, patients frequently experience declined functional capacity due to immobilization and pain, hindering recovery. This study aims to evaluate the effect of a Phase II cardiac rehabilitation exercise program on improving functional capacity in post-CABG patients. A quantitative analytical observational approach was used with a prospective cohort design involving a single group. The sample consisted of 40 postoperative patients who completed 12 sessions of Phase II cardiac rehabilitation, including aerobic warm-ups, static cycling (25 watts for 10 minutes), and treadmill or track walking. Functional capacity was measured using the Six-Minute Walk Test (6MWT) and Metabolic Equivalents (METs), converted via the Cahalin formula before and after the intervention. The findings showed a significant increase in METs after the intervention ($p = 0.023$; $\alpha < 0.05$), with most patients improving from the moderate category (4–6 METs) to the good (>6–8 METs) and very good (>8 METs) categories. Statistical analysis using the Wilcoxon test yielded a Z-value of -2.271 ($p = 0.023$), indicating significant functional capacity improvement. Phase II cardiac rehabilitation is effective in enhancing functional capacity in post-CABG patients. Active participation is recommended for ongoing recovery.Downloads
References
Aquino, T. N., Prado, J. P., Crisafulli, E., Clini, E. M., & Galdino, G. (2024). Efficacy of respiratory muscle training in the immediate postoperative period of cardiac surgery: A systematic review and meta-analysis. Brazilian Journal of Cardiovascular Surgery, 39(1), e20220165. https://doi.org/10.21470/1678-9741-2022-0165
Araújo, C. O., Alves, C. C. A., Dos Santos, F. R. A., Cahalin, L. P., Cipriano, G. F. B., & Cipriano, G. (2024). Inspiratory muscle training in phase 1 and 2 postoperative cardiac rehabilitation following coronary artery bypass graft surgery: Systematic review with meta-analysis. Physical Therapy, 104(7), pzae061. https://doi.org/10.1093/ptj/pzae061
ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. (2002). ATS statement: Guidelines for the six-minute walk test. American Journal of Respiratory and Critical Care Medicine, 166(1), 111-117. https://doi.org/10.1164/ajrccm.166.1.at1102
Badan Kebijakan Pembangunan Kesehatan. (2024). Survei Kesehatan Indonesia (SKI) dalam Angka. Kementerian Kesehatan Republik Indonesia.
Brown, T. M., Pack, Q. R., Aberegg, E., Brewer, L. C., Ford, Y. R., Forman, D. E., Gathright, E. C., Khadanga, S., Ozemek, C., & Thomas, R. J. (2024). Core components of cardiac rehabilitation programs: 2024 update: A scientific statement from the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation, 150(18),
e328-e347. https://doi.org/10.1161/CIR.0000000000001289
Cahalin, L. P., Mathier, M. A., Semigran, M. J., Dec, G. W., & DiSalvo, T. G. (1996). The six-minute walk test predicts peak oxygen uptake and survival in patients with advanced heart failure. Chest, 110(2), 325-332. https://doi.org/10.1378/chest.110.2.325
Cordeiro, A. L. L., Soares, L. O., Gomes-Neto, M., & Petto, J. (2023). Inspiratory muscle training in patients in the postoperative phase of cardiac surgery: A systematic review and meta-analysis. Annals of Rehabilitation Medicine, 47(3), 162-172. https://doi.org/10.5535/arm.23022
Dibben, G. O., Faulkner, J., Oldridge, N., Rees, K., Thompson, D. R., Zwisler, A.-D., & Taylor, R. S. (2021). Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database of Systematic Reviews, 2021(11), CD001800. https://doi.org/10.1002/14651858.CD001800.pub4
Dibben, G. O., Faulkner, J., Oldridge, N., Rees, K., Thompson, D. R., Zwisler, A.-D., & Taylor, R. S. (2023). Exercise-based cardiac rehabilitation for coronary heart disease: A meta-analysis. European Heart Journal,
(6), 452-469. https://doi.org/10.1093/eurheartj/ehac747
Global Burden of Cardiovascular Diseases and Risks 2023 Collaborators. (2025). Global, regional, and national burden of cardiovascular diseases and risk factors in 204 countries and territories, 1990-2023. Journal of the American College of Cardiology, 86(22), 2167-2243. https://doi.org/10.1016/j.jacc.2025.08.015
Holland, A. E., Spruit, M. A., Troosters, T., Puhan, M. A., Pepin, V., Saey, D., McCormack, M. C., Carlin, B. W., Sciurba, F. C., Pitta, F., Wanger, J., MacIntyre, N., Kaminsky, D. A., Culver, B. H., Revill, S. M., Hernandes, N. A., Andrianopoulos, V., Camillo, C. A., Mitchell, K. E., ... Mohan, V. (2014). An official European Respiratory Society/American Thoracic Society technical standard: Field walking tests in chronic respiratory disease. European Respiratory Journal, 44(6), 1428-1446. https://doi.org/10.1183/09031936.00150314
Khuangsirikul, W., Jalayondeja, W., Chuanchaiyakul, R., Krittayaphong, R., Chotinaiwattarakul, C., & Laksanabunsong, P. (2014). Metabolic
equivalent of exercise stress test explained by six-minute walk test in post coronary artery bypass graft and post percutaneous coronary intervention patients. Journal of the Medical Association of Thailand, 97(Suppl. 7), S6-S9.
Kirkman, D. L., Lee, D.-C., & Carbone, S. (2022). Resistance exercise for cardiac rehabilitation. Progress in Cardiovascular Diseases, 70, 66-72. https://doi.org/10.1016/j.pcad.2022.01.004
Lawton, J. S., Tamis-Holland, J. E., Bangalore, S., Bates, E. R., Beckie, T. M., Bischoff, J. M., Bittl, J. A., Cohen, M. G., DiMaio, J. M., Don, C. W., Fremes, S. E., Gaudino, M. F., Goldberger, Z. D., Grant, M. C., Jaswal, J. B., Kurlansky, P. A., Mehran, R., Metkus, T. S., Nnacheta, L. C., ... Zwischenberger, B. A. (2022). 2021 ACC/AHA/SCAI guideline for coronary artery revascularization: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology, 79(2), e21-e129. https://doi.org/10.1016/j.jacc.2021.09.006
Miao, J., Yang, H., Shi, R., & Wang, C. (2023). The effect of cardiac rehabilitation on cardiopulmonary function after coronary artery bypass grafting: A systematic review and meta-analysis. iScience, 26(12), 107861. https://doi.org/10.1016/j.isci.2023.107861
Radi, B., Ambari, A. M., Dwiputra, B., Intan, R. E., Triangto, K., Santoso, A., & Setianto, B. (2021). Determinants and prediction equations of six-minute walk test distance immediately after cardiac surgery. Frontiers in Cardiovascular Medicine, 8, 685673. https://doi.org/10.3389/fcvm.2021.685673
Sohn, S., Jeon, J., Lee, J. E., Park, S. H., Kang, D. O., Park, E. J., Lee, D.-I., Choi, J. Y., Roh, S. Y., Na, J. O., Choi, C. U., Kim, J. W., Rha, S. W., Park, C. G., Lee, S., & Kim, E. J. (2025). Prognostic value of the six-minute walk test in patients with cardiovascular disease. Scientific Reports, 15, 20817. https://doi.org/10.1038/s41598-025-04480-9
Subih, M., Elshatarat, R. A., Sawalha, M. A., Almarwani, A. M., Alhadidi, M., Alrahahleh, M., Elneblawi, N. H., Saleh, Z. T., Abdelkader, R., Almagharbeh, W. T., Eltayeb, M., & Mohamed, N. A. (2024). Exploring the impact of cardiac rehabilitation programs on health-related quality of life and physiological outcomes in patients post coronary artery bypass grafts: A systematic review. Reviews in Cardiovascular Medicine, 25(4), 145. https://doi.org/10.31083/j.rcm2504145
Taylor, R. S., Dalal, H. M., & McDonagh, S. T. J. (2022). The role of cardiac rehabilitation in improving cardiovascular outcomes. Nature Reviews Cardiology, 19(3), 180-194. https://doi.org/10.1038/s41569-021-00611-7
Thomas, R. J., Beatty, A. L., Beckie, T. M., Brewer, L. C., Brown, T. M., Forman, D. E., Franklin, B. A., Keteyian, S. J., Kitzman, D. W., Regensteiner, J. G., Sanderson, B. K., & Whooley, M. A. (2019). Home-based cardiac rehabilitation: A scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Circulation, 140(1), e69-e89. https://doi.org/10.1161/CIR.0000000000000663
Vrints, C. J. M., Andreotti, F., Christodorescu, R. M., Deaton, C., Doenst, T., Jones, H. W., Koskinas, K. C., Rossello, X., Winther, S., & ESC Scientific Document Group. (2024). 2024 ESC guidelines for the management of chronic coronary syndromes. European Heart Journal, 45(36), 3415-3537. https://doi.org/10.1093/eurheartj/ehae177
Wongvibulsin, S., Habeos, E. E., Huynh, P. P., Xun, H., Shan, R., Porosnicu Rodriguez, K. A., Wang, J., Gandapur, Y. K., Osuji, N., Shah, L. M., Spaulding, E. M., Hung, G., Knowles, K., Yang, W. E., Marvel, F. A., Levin, E., Maron, D. J., Gordon, N. F., & Martin, S. S. (2021). Digital health interventions for cardiac rehabilitation: Systematic literature review. Journal of Medical Internet Research, 23(2), e18773. https://doi.org/10.2196/18773
Wu, C., Bu, R., Wang, Y., Xu, C., Chen, Y., Che, L., & Wang, S. (2022). Rehabilitation effects of circuit resistance training in coronary heart disease patients: A systematic review and meta-analysis. Clinical Cardiology, 45(8), 821-830. https://doi.org/10.1002/clc.23855
Published
Issue
Section
Copyright (c) 2026 Lilis Suhaini, Tri Mustikowati, Widanarti Setyaningsih
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
