European Journal of Biomedical and Pharmaceutical Sciences

EFFECTIVENESS OF HOME-BASED VERSUS CENTER-BASED PHASE II CARDIAC REHABILITATION ON QUALITY OF LIFE IN POST-CORONARY ARTERY BYPASS GRAFT PATIENTS: A RANDOMIZED CONTROLLED TRIAL

Shehanshah Kazmi*

ABSTRACT

Background: Cardiac rehabilitation (CR) is a guideline-recommended, comprehensive secondary-prevention intervention that reduces mortality and improves quality of life (QOL) after coronary artery bypass grafting (CABG). Whether center-based or home-based delivery of Phase II CR yields comparable benefit remains debated, particularly in low-resource settings. Objective: To compare the effectiveness of center-based and home-based Phase II cardiac rehabilitation on health-related quality of life in post-CABG patients. Design: Randomized controlled trial. Setting: Physiotherapy Department, Kulsum International Hospital, Islamabad, Pakistan. Participants: Forty post-CABG patients aged >30 years, recruited within three months of surgery and randomly allocated by lottery method to a center-based group (n = 20) or a home-based group (n = 20). Interventions: Both groups completed a structured, 4-week, thrice-weekly Phase II exercise protocol comprising warm-up, aerobic conditioning, and cool-down components. The center-based group trained under direct supervision with telemetry monitoring; the home-based group followed a prescribed home-exercise pamphlet with weekly telephone monitoring. Outcome Measure: Health-related quality of life was assessed with the SF-36 questionnaire at baseline (Week 1, post-discharge) and after 4 weeks. Within-group change was analyzed using the paired-samples t-test; between-group differences were analyzed using the independent-samples t-test (SPSS v.21, α = 0.05). Results: Both groups showed statistically significant within-group improvement (p < 0.05) across nearly all SF-36 domains from Week 1 to Week 4. The center-based group demonstrated numerically larger gains in physical functioning, role limitation (physical and emotional), social function, pain, and general health, while emotional well-being improved comparably in both groups. Conclusion: Center-based Phase II cardiac rehabilitation was associated with greater improvement in quality of life than home-based rehabilitation, plausibly reflecting closer supervision and higher patient confidence; nonetheless, home-based rehabilitation produced meaningful gains and remains a valuable alternative where access to a center is limited.

Keywords: cardiac rehabilitation; coronary artery bypass graking; quality of life; SF-36; home-based rehabilitation; center-based rehabilitation; Phase II rehabilitation.