Original article / research
Effectiveness of Leg Cycle Ergometry Exercise on Functional Capacity, Muscle Strength and Quality of Life in Post-CABG Patients: A Systematic Review
YC07-YC11
Correspondence
Dr. Deepali Dattaram Vinerkar,
Resident, Department of Cardiovascular and Respiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Sawangi (Meghe), Wardha-442001, Maharashtra, India.
E-mail: deepalivinerkar13@gmail.com
Introduction: Coronary Artery Bypass Grafting (CABG) is performed to restore myocardial perfusion and reduce morbidity in patients with coronary artery disease. Postoperative patients commonly experience reduced functional capacity, respiratory muscle weakness and limited exercise tolerance, necessitating structured rehabilitation. Leg cycle ergometry has gained increasing interest as an early rehabilitation.
Aim: To systematically review Randomised Controlled Trials (RCT) evaluating the effectiveness of leg cycle ergometry in postoperative rehabilitation following CABG surgery. This systematic review was registered in PROSPERO. The review was structured according to the PICOTS framework: Population - adult CABG patients; Intervention - leg cycle ergometry; Comparator - standard physiotherapy, walking, or resistance training; Outcomes - functional capacity, muscle strength, pulmonary function and quality of life; Timing - immediate postoperative period; Study design - RCTs.
Materials and Methods: The present review was conducted in the Department of Cardiovascular and Respiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India followed Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and was registered in International Prospective Register of Systematic Reviews (PROSPERO). A comprehensive search was conducted in PubMed, Scopus and Nested Knowledge (2015-2025). Eligible studies were RCTs involving adult patients undergoing CABG who were also undergoing postoperative leg cycle ergometry. Data extraction followed a standardised format and the Cochrane RoB-2 tool was used to assess risk of bias. The review followed the Population, Intervention, Comparison, Outcome and Time (PICOTS) framework. The search strategy included combinations of keywords using Boolean operators (“CABG”, “coronary artery bypass”, “leg cycle ergometry”, “aerobic training”, “early mobilisation”) across PubMed, Scopus and Nested Knowledge. Only RCTs involving adult CABG patients who received leg cycle ergometry were included. Studies involving other cardiac surgeries or non randomised designs were excluded.
Results: From 223 records, five RCTs met the inclusion criteria. Overall, the included RCTs demonstrated consistent improvements across major postoperative outcomes. Leg cycle ergometry performed for 1-3 weeks resulted in significantly greater gains in functional capacity and lower-limb strength compared with standard physiotherapy alone. Respiratory muscle strength was better preserved in studies measuring Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP), and additional benefits were noted in psychological outcomes {Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder 7 (GAD-7)}, sleep quality {Pittsburgh Sleep Quality Index (PSQI)} and overall quality of life {36-Item Short Form Survey (SF-36)}. However, heterogeneity in intervention duration, exercise intensity and outcome tools limited direct comparison of effect sizes. Three studies were rated as low-risk of bias, while two presented some concerns.
Conclusion: Leg cycle ergometry is an effective and safe adjunct in early post-CABG rehabilitation. Further standardised RCTs are warranted to strengthen evidence for widespread clinical implementation.