Psychosocial interventions to optimize recovery of physical function and facilitate engagement in physical activity during the first three months following CABG surgery: a systematic review

Abstract

Background

Physical activity following coronary artery bypass graft (CABG) surgery is linked to improved short and long-term outcomes. However, uptake of cardiac rehabilitation programs is low following CABG surgery. Psychosocial interventions have been identified as possible ways to increase exercise participation and adherence.

Objectives

To undertake a systematic review to investigate the effectiveness of psychosocial interventions on improving engagement in physical activity and optimizing physical function during the first three months following CABG surgery. The secondary aim was to identify the self-management strategies and/or behavior change techniques that were incorporated into post-CABG rehabilitation programs described in the literature.

Methods

A search strategy was developed and used across nine electronic databases. Records were screened against eligibility criteria developed by the research team. Methodological quality was assessed using the Joanna Briggs Institute checklists.

Results

Eighteen articles were included in the review. All used at least one behavioral change technique; 2/18 included self-management strategies. Sixteen studies demonstrated an improvement and there was a significantly superior effect of the intervention on physical activity engagement or physical function compared to usual care in 11/18 studies. The effect was superior in females only, in 1/11 studies. Patient education was the predominant psychosocial intervention.

Conclusions

Whilst psychosocial interventions demonstrated benefits for patients, the interventions used did not equip the participants with the skills required to optimize self-management. Further studies to investigate the effectiveness of self-management strategies are required to determine the most effective strategies to improve physical activity levels, and physical functioning in early rehabilitation post-CABG.

Keywords:

• Coronary artery bypass graft
• self-management
• behavior change
• physical activity
• physical function

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Acknowledgement

The authors would like to acknowledge Thelma Fisher, the Health Sciences Librarian at University of Otago, who helped with the development of the search strategy and employment of databases.

Disclosure statement

None of the authors reported any conflicts of interest.

Additional information

Notes on contributors

Emily Gray

The first five authors are Bachelor of Physiotherapy students in their final year of the degree program. The review was undertaken as part of the requirements for their degree. Emily Gray was the project co-supervisor and is also a PhD candidate whose research relates to motivators and barriers for physical activity in patients post discharge following coronary artery bypass grafting. Dr Margot Skinner, the other co-supervisor, also has a research interest in motivators for physical activity and is primary supervisor for the PhD project.