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Preoperative Breathing Techniques and Functional Mobility in CABG Patients


At HolistiCare Physical Therapy, we are dedicated to integrating the latest research into our practice to provide the best care for our patients. A recent comprehensive review by Sahar et al. (2024) evaluates the effects of preoperative breathing techniques on functional mobility in patients undergoing coronary artery bypass graft (CABG) surgery, comparing on-pump and off-pump methods. This article highlights key findings from the review, demonstrating how preoperative physiotherapy can significantly improve patient outcomes.

The Importance of Preoperative Physiotherapy

Coronary artery disease (CAD) is a leading cause of death globally, often necessitating CABG surgery. However, this procedure carries risks of postoperative pulmonary complications (PPCs), such as pneumonia and atelectasis, which can prolong hospital stays and increase healthcare costs (Sahar et al., 2024). Preoperative physiotherapy, including breathing exercises and inspiratory muscle training (IMT), plays a crucial role in mitigating these risks by enhancing lung function and reducing anxiety.

Techniques in Preoperative Physiotherapy

The review discusses various preoperative chest rehabilitation techniques, such as:

  • Incentive Spirometry: Encourages deep breathing to prevent lung complications.
  • Deep Breathing Exercises: Improve oxygenation and lung capacity.
  • Inspiratory Muscle Training (IMT): Strengthens respiratory muscles, reducing the incidence of PPCs (Sahar et al., 2024).

These techniques are designed to prepare patients for surgery by improving respiratory efficiency and overall physical readiness.

Comparing On-Pump and Off-Pump CABG

The choice between on-pump and off-pump CABG remains debated. On-pump CABG involves cardiopulmonary bypass, providing a stable surgical field but with higher risks of complications. Off-pump CABG eliminates the need for bypass, potentially reducing these risks but presenting its own challenges (Sahar et al., 2024). Preoperative physiotherapy is essential in both methods to optimize pulmonary function and reduce postoperative complications.

Impact of Preoperative Breathing Techniques

The review highlights several benefits of preoperative breathing techniques:

  • Reduced PPCs: Studies show a significant decrease in PPCs among patients who undergo preoperative physiotherapy.
  • Shortened Hospital Stays: Effective preoperative interventions lead to quicker recovery times and shorter hospitalizations.
  • Improved Functional Mobility: Patients demonstrate better functional mobility and respiratory function post-surgery (Sahar et al., 2024).

For example, one study included in the review found that patients who engaged in daily preoperative respiratory exercises experienced enhanced inspiratory muscle strength and reduced hospital stay durations (Sahar et al., 2024).

Recommendations for Clinical Practice

Based on the findings of the review, the following recommendations are made for integrating preoperative physiotherapy into clinical practice:

  1. Incorporate Routine Preoperative Assessments: Evaluate patients’ respiratory function and tailor physiotherapy plans accordingly.
  2. Implement Comprehensive Breathing Programs: Include a combination of IMT, incentive spirometry, and deep breathing exercises.
  3. Provide Patient Education: Educate patients on the benefits of preoperative physiotherapy and proper techniques to enhance adherence and outcomes (Sahar et al., 2024).

By adopting these practices, healthcare providers can improve the surgical outcomes and overall well-being of patients undergoing CABG surgery.

The review by Sahar et al. (2024) underscores the importance of preoperative breathing techniques in enhancing functional mobility and reducing complications in CABG patients. At HolistiCare Physical Therapy, we are committed to incorporating these evidence-based practices to ensure optimal patient care and recovery.



Sahar, W., Elengoe, A., Jalal, A., Batool, S. A., Haider, Z., & Jaffar, H. M. (2024). Evaluation of Preoperative Breathing Techniques on Functional Mobility in On-Pump Versus Off-Pump Coronary Artery Bypass Graft Patients: A Comprehensive Review. Pakistan Heart Journal, 57(2), 79–88.