20 Effects of a progressive moderate-to-high (ProMoHi) intensity aerobic and resistance training in a hybrid cardiac rehabilitation exercise program (CREP) on physical function, psychological status, health status and quality of life in patients post

<h3>Background</h3> Cardiac rehabilitation for post-CABG patients is evolving, with traditional center-based programs demonstrating benefits but struggling with low participation rates. While promising home-based alternatives offer potential, their lack of standardized protocols limiting widespread adoption. The Hybrid Cardiac Rehabilitation Exercise Program (CREP) integrates elements from both models to enhance patient engagement and adherence. Nevertheless, the monitoring of exercise and the implementation of hybrid components remain limited, particularly in low-resources countries such as Malaysia. <h3>Aims</h3> This prospective randomized controlled trial aims to assess the safety and feasibility, efficacy and adherence of an individualised progressive moderate-to-high aerobic and resistance training in a Hybrid CREP, in post-CABG patients. <h3>Methods</h3> Participants aged 18 and older scheduled for CABG surgery due to coronary artery disease will be recruited preoperatively and randomized 1:1 into either the Hybrid ProMoHi or standard care (i.e., centre-based CREP) group, postoperatively. Primary outcomes including exercise capacity, muscular strength, and quality of life, will be evaluated using the 6-Minute Walk Test, Unsupported Upper Limb Exercise Test, Jamar Handgrip Test, 30-Second Sit-to-Stand Test, and EuroQol-5D-5L. Secondary measures will include safety and feasibility, health status, and psychological parameters using the HADS questionnaire. Assessments will occur at baseline (preoperatively), at 2, 6, and 10 weeks postoperatively. <h3>Conclusion</h3> This RCT will have been the first to explore the safety and feasibility, efficacy and adherence to the hybrid CREP in Malaysia setting. The findings of this RCT are expected to facilitate the design and implementation of a Hybrid CREP in any resource-limited countries like Malaysia.