Rehabilitation Interventions After Cardiac Surgery in Older Adults

Rehabilitation Interventions After Cardiac Surgery in Older Adults: A Randomized Controlled Trial

This randomized controlled trial aims to investigate the effects of foot massage and kinesio taping on functional performance and kinesiophobia in older adults following cardiac surgery. Early mobilization after cardiac surgery is essential for improving recovery outcomes; however, pain, fear of movement (kinesiophobia), and reduced functional capacity may delay rehabilitation in older patients.

Participants aged 65 years and older who have undergone cardiac surgery will be randomly assigned to either a foot massage group or a kinesio taping group. The foot massage group will receive daily bilateral foot massage for seven consecutive days, while the kinesio taping group will receive standardized kinesio taping applications to the foot and ankle region during the same period.

Functional performance, kinesiophobia, pain intensity, cognitive status, and delirium will be assessed using validated outcome measures, including the Timed Up and Go test, Tampa Scale for Kinesiophobia, Visual Analog Scale, Standardized Mini-Mental Test, and Nursing Delirium Screening Scale. Assessments will be conducted preoperatively and on the seventh postoperative day.

The study aims to determine whether non-pharmacological, easily applicable interventions such as foot massage and kinesio taping can enhance functional recovery, reduce fear of movement, and support early mobilization in older adults after cardiac surgery.

Cardiac surgery is associated with significant postoperative physical and psychological challenges, particularly in older adults. Age-related physiological changes, combined with the effects of major surgery, often result in decreased functional capacity, delayed mobilization, increased pain levels, and heightened fear of movement (kinesiophobia). Early mobilization is a key component of postoperative recovery; however, pain and psychological barriers may limit patients' willingness and ability to participate in rehabilitation processes.

Non-pharmacological interventions that are safe, simple, and easily applicable in clinical settings may play an important role in improving recovery outcomes. Foot massage is a widely used supportive intervention that can enhance circulation, stimulate sensory receptors, promote relaxation, and reduce pain perception. Similarly, kinesio taping is a non-invasive therapeutic approach that may improve proprioception, support joint stability, enhance circulation, and reduce pain through neuromuscular mechanisms.

Despite the potential benefits of these interventions, there is limited evidence regarding their effectiveness in older adults following cardiac surgery, particularly in relation to functional performance and kinesiophobia. Moreover, studies investigating the combined relationship between pain, functional mobility, and fear of movement in this population remain scarce.

The present study is designed as a randomized controlled trial to evaluate the effects of foot massage and kinesio taping on functional performance and kinesiophobia in older adults after cardiac surgery. Participants aged 65 years and older who have undergone cardiac surgery (e.g., coronary artery bypass grafting or valve surgery) and meet the inclusion criteria will be recruited from a tertiary hospital setting.

Eligible participants will be randomly assigned to one of two intervention groups: a foot massage group or a kinesio taping group. The foot massage group will receive standardized bilateral foot massage using the Swedish massage technique for 20 minutes daily over a 7-day postoperative period. The kinesio taping group will receive kinesio taping applications applied to the foot and ankle region according to standardized procedures, with applications repeated during the same 7-day period.

Outcome measures will include functional performance assessed by the Timed Up and Go (TUG) test, kinesiophobia assessed by the Tampa Scale for Kinesiophobia (TSK), pain intensity assessed by the Visual Analog Scale (VAS), cognitive status assessed by the Standardized Mini-Mental Test (SMMT), and delirium status assessed by the Nursing Delirium Screening Scale (Nu-DESC). Assessments will be conducted preoperatively and on the seventh postoperative day.

The primary objective of this study is to compare the effects of foot massage and kinesio taping on functional performance. Secondary objectives include evaluating their effects on kinesiophobia, pain, cognitive status, and delirium. It is hypothesized that both interventions will improve functional outcomes, with kinesio taping having a greater effect on reducing kinesiophobia and foot massage having a stronger effect on pain reduction.

The findings of this study are expected to contribute to the development of effective, low-cost, and easily implementable rehabilitation strategies that support early mobilization and improve postoperative recovery in older adults undergoing cardiac surgery.

Inclusion Criteria:

• Age ≥65 years
• Undergoing cardiac surgery (e.g., coronary artery bypass grafting or valve surgery)
• Conscious and able to cooperate
• Able to provide informed consent

Exclusion Criteria:

• Presence of neurological disorders (e.g., stroke, Parkinson's disease)
• Lower extremity amputation or severe deformity
• Impaired skin integrity in the application area
• Contraindications to massage or kinesio taping
• Refusal to participate