The Effect of Modified Cardiac Rehabilitation on Erectile Dysfunction and Coping with Stress in Men Undergoing Coronary Artery Bypass Graft (CABG): A Clinical Trial

  • Peyman Kaikhosro Doulatyari
  • Mohammad GholamiEmail author
  • Tahereh Toulabi
  • Mehdi Birjandi
  • Alireza Abdi
Original Paper


Erectile dysfunction and stress are among common post-CABG surgery complications. The present study was conducted to assess the effect of modified cardiac rehabilitation on “erectile dysfunction” and “coping with stress”. In the present clinical trial study, 126 male patients undergoing CABG surgery were randomly assigned to treatment (63 patients) and control (63 patients) groups. Control group received conventional cardiac rehabilitation program over 26 sessions. Treatment group received modified cardiac rehabilitation program, including Kegel exercise and training on stress coping strategies in the first four sessions of their rehabilitation program. Patients were assessed before and after cardiac rehabilitation program using the International Index of Erectile Dysfunction (IIEF-5) questionnaire and Endler and Parker Coping with Stress Scale. Data were analyzed in SPSS using ANOVA, T, and Chi square tests. Mean erectile function score significantly increased in both treatment and control groups, but the difference in mean scores for improvement in erectile function was greater in treatment group (P < 0.001). Analysis showed no significant difference in mean differences between two groups in all subscales of stress coping. Intragroup analysis showed significant differences in both groups between mean differences before and after intervention in task-oriented styles {treatment group (P < 0.002), control group (P < 0.001)}, and social diversion-oriented. The results showed that conventional and modified cardiac rehabilitation can be effective in improving erectile dysfunction and stress coping in task-oriented and social diversion-oriented styles in the men patients with left ventricular ejection fraction over 30% following CABG surgery. However, modified cardiac rehabilitation has greater benefits for improving erectile dysfunction.


Cardiac rehabilitation Erectile dysfunction Coping with stress CABG patients Iran 



International Index of Erectile Dysfunction


Coping with Stress Scale


Body mass index



The current study was resulted in a critical care dissertation approved by Lorestan University of Medical Sciences, as well as it is approved by Iranian registry of clinical trial with No. 2017082324080N12, hence, we are grateful of the officials of research deputy and nursing and midwifery school of the university, as well as the officials of Imam Ali hospital of Kermanshah and the patients who participated in the study.

Authors’ Contribution

PKD, MG and TT, BM contributed in designing the study, PKD and MG collected the data, and analyzed by BM, TT and AA, the final report and article were written by PKD, MG, and AA, and it was read and approved by all the authors.


The study was funded by Lorestan University of Medical Sciences.

Compliance with Ethical Standards

Conflict of interest

All authors declare, there is no conflict of interest.

Human and Animal Rights

All procedures that performed for the patients were in line with ethical standards of human right, wherein we took written informed consent and they assured about the anonymity and confidentiality of personal information, also the project was approve by research ethics committee of Lorestan University of medical sciences with number Lums.REC.1395.120.

Informed Consent

Written informed consent was taken from the participants.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Peyman Kaikhosro Doulatyari
    • 1
  • Mohammad Gholami
    • 2
    Email author
  • Tahereh Toulabi
    • 2
  • Mehdi Birjandi
    • 3
  • Alireza Abdi
    • 4
  1. 1.Student Research CommitteeLorestan University of Medical SciencesKhorramabadIran
  2. 2.School of Nursing and Midwifery, Social Determinants of Health Research CenterLorestan University of Medical SciencesKhorramabadIran
  3. 3.Biostatistics Department, School of HealthLorestan University of Medical SciencesKhorramabadIran
  4. 4.School of Nursing and midwifery, Student Research CommitteeKermanshah University of Medical SciencesKermanshahIran

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