4 DISCUSSION
Cardiac rehabilitation programs for those patients could present a reasonably acceptable method to promote the smooth transition of patients to their new life post CABG. The impact of (CRP) on patient health outcomes, including adaptation in lifestyle and improved bio-physiological markers, has been well-documented in the literature.18
This review assessed the impact of CRP on CABG patients in terms of improving the HRQoL and their physiological outcomes. Most of the literature involved in this review mentioned the content for their CRP content (different dimensions of health-promoting behaviors (HPBs) such as dietary counseling, smoking cessation…, physiotherapy, breathing exercises, psychological counseling, pharmacological treatment. Facts about their illness, clinical manifestations, and potential complications), and the ways of applying these types of CRP (face to face training, educational booklet and a pamphlet, lecture, demonstration, question‑and‑answer, reinforcement, feedback‑giving, and summarization, follow‑up telephone, and home visits). The most common outcomes measured were HRQOL and physiological variables which CRP displayed a positive effect on these outcomes. The number of sessions and duration varies from 4 sessions, 45-60 minutes10,14 to 3 times training/week for 12 weeks12, to 60-220 min sessions9, to 16 sessions (15 minutes each) 11, and 7 times/week for 3 weeks (inpatients) with 2 training sessions daily, 45 minutes, each, to 5 times/week for 6 months (outpatients).15 One study by Akbari et al.9 includes family caregivers in the CRP, by training them to help patients achieve self‑care activities post‑discharge. Multi health professionals can give rehabilitation interventions, some given by intensive care unit nurses, some were physiotherapists, some studies used dietitians, physicians, and others. Some studies reported some major limitations that may affect the generalizability or external validity, such as small sample8,11,13,15, in addition to selection problems of participants12, or using convenience sampling method; no randomization or random assignment.9 Also, short follow-up period8-11, single-center of CRP /single geographic area.8,13 Illiteracy of participants10, no control group, and muscle training was not telemonitored.12 Finally, not enough data for economic evaluation.13