ReviewCureus2025
Effectiveness of Combined Preoperative and Postoperative Rehabilitation Versus Postoperative-Only Rehabilitation in Cardiac Surgery Patients: A Systematic Review.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Prehabilitation Before Cardiac Surgery and Structural Heart Interventions: An Umbrella Review of Pooled Evidence.Journal of clinical medicine · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Prehabilitation, delivered before surgery in addition to standard postoperative rehabilitation, has been proposed as a strategy to improve outcomes in patients undergoing cardiac surgery. While postoperative rehabilitation is standard of care, the incremental benefit of adding a preoperative phase remains uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies comparing combined preoperative and postoperative rehabilitation (Pre+Post) with postoperative rehabilitation alone (Post-only) in adults undergoing elective cardiac surgery. Comprehensive searches of PubMed, CINAHL, Cochrane, and MEDLINE were performed up to March 2025. Primary outcomes were postoperative pulmonary complications (PPCs), functional capacity, pulmonary function, and length of hospital stay (LOS). Secondary outcomes included ICU stay, duration of mechanical ventilation, quality of life (QoL), and psychological measures. The risk of bias was assessed using the RoB 2 tool for RCTs. Pooled analyses were conducted using random-effects models. Seventeen studies met the inclusion criteria, comprising 11 RCTs and six non-randomized studies, with over 3,200 participants. Meta-analysis of six RCTs (n = 1,729) showed that Pre+Post rehabilitation significantly reduced PPCs (RR 0.39, 95% CI 0.19-0.80, p = 0.01), corresponding to a 61% lower risk. Four RCTs (n = 315) demonstrated superior postoperative functional capacity in the Pre+Post group, with a pooled mean difference of +42 m in 6MWT (95% CI 32.39-51.68, p < 0.00001, I² = 0%). Pulmonary function was improved, with increases in FVC (+0.45 L, 95% CI 0.20-0.70) and FEV₁ (+0.36 L, 95% CI 0.14-0.58). Hospital LOS was reduced by almost three days (MD -2.92, 95% CI -4.52 to -1.31), though heterogeneity was high (I² = 87%). Effects on ICU stay and QoL were mixed. Adding a structured prehabilitation phase to standard postoperative rehabilitation significantly reduces PPCs, improves functional capacity, and enhances pulmonary function after cardiac surgery. While benefits on LOS and QoL are less consistent, the overall evidence supports the integration of prehabilitation into perioperative care pathways. Future large-scale RCTs with standardized protocols are warranted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.