Inspiratory Muscle Training and Functional Capacity in Patients Undergoing Cardiac Surgery

André Luiz Lisboa Cordeiro, Thiago Araújo de Melo, Daniela Neves, Julianne Luna, Mateus Souza Esquivel, André Raimundo França Guimarães, Daniel Lago Borges, Jefferson Petto, André Luiz Lisboa Cordeiro, Thiago Araújo de Melo, Daniela Neves, Julianne Luna, Mateus Souza Esquivel, André Raimundo França Guimarães, Daniel Lago Borges, Jefferson Petto

Abstract

Introduction: Cardiac surgery is a highly complex procedure which generates worsening of lung function and decreased inspiratory muscle strength. The inspiratory muscle training becomes effective for muscle strengthening and can improve functional capacity.

Objective: To investigate the effect of inspiratory muscle training on functional capacity submaximal and inspiratory muscle strength in patients undergoing cardiac surgery.

Methods: This is a clinical randomized controlled trial with patients undergoing cardiac surgery at Instituto Nobre de Cardiologia. Patients were divided into two groups: control group and training. Preoperatively, were assessed the maximum inspiratory pressure and the distance covered in a 6-minute walk test. From the third postoperative day, the control group was managed according to the routine of the unit while the training group underwent daily protocol of respiratory muscle training until the day of discharge.

Results: 50 patients, 27 (54%) males were included, with a mean age of 56.7±13.9 years. After the analysis, the training group had significant increase in maximum inspiratory pressure (69.5±14.9 vs. 83.1±19.1 cmH2O, P=0.0073) and 6-minute walk test (422.4±102.8 vs. 502.4±112.8 m, P=0.0031).

Conclusion: We conclude that inspiratory muscle training was effective in improving functional capacity submaximal and inspiratory muscle strength in this sample of patients undergoing cardiac surgery.

References

    1. Laizo A, Delgado FE, Rocha GM. Complications that increase the time of hospitalization at ICU of patients submitted to cardiac surgery. Rev Bras Cir Cardiovasc. 2010;25(2):166–171.
    1. Pinheiro AR, Christofoletti G. Motor physical therapy in hospitalized patients in an intensive care unit: a systematic review. Rev Bras Ter Intensiva. 2012;24(2):188–196.
    1. França EÉ, Ferrari F, Fernandes P, Cavalcanti R, Duarte A, Martinez BP, et al. Physical therapy in critically ill adult patients: recommendations of the Brazilian Association of Intensive Care Medicine Department of Physical Therapy. Rev Bras Ter Intensiva. 2012;24(1):6–22.
    1. Shakouri SK, Salekzamani Y, Taghizadieh A, Sabbagh-Jadid H, Soleymani J, Sahebi L, et al. Effect of respiratory rehabilitation before open cardiac surgery on respiratory function: a randomized clinical trial. J Cardiovasc Thorac Res. 2015;7(1):13–17.
    1. Oliveira EK, Silva VZ, Turquetto AL. Relationship on walk test and pulmonary function with the length of hospitalization in cardiac surgery patients. Rev Bras Cir Cardiovasc. 2009;24(4):478–484.
    1. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111–117.
    1. Pires SR, Oliveira AC, Parreira VF, Brito RR. Teste de caminhada de seis minutos em diferentes faixas etárias e índices de massa corporal. Rev Bras Fisioter. 2007;11(2):147–151.
    1. Soares MR, Pereira CA. Six-minute walk test: reference values for healthy adults in Brazil. J Bras Pneumol. 2011;37(5):576–583.
    1. Veloso-Guedes CA, Rosalen ST, Thobias CM, Andreotti RM, Gallardo FD, et al. Oliveira da Silva AM. Validation of 20-meter corridor for the 6-minute walk test in men on liver transplantation waiting list. Transplant Proc. 2011;43(4):1322–1324.
    1. Carey EJ, Steidley DE, Aqel BA, Byrne TJ, Mekeel KL, Rakela J, et al. Six-minute walk distance predicts mortality in liver transplant candidates. Liver Transpl. 2010;16(12):1373–1378.
    1. Iwama AM, Andrade GN, Shima P, Tanni SE, Godoy I, Dourado VZ. The six-minute walk test and body weight-walk distance product in healthy Brazilian subjects. Braz J Med Biol Res. 2009;42(11):1080–1085.
    1. Badenes R, Belda FJ, Aguilar G. Mechanical ventilation in cardiac surgery. Curr Anaesth Crit Care. 2010;21(5-6):250–254.
    1. Barros GF, Santos CS, Granado FB, Costa PT, Límaco RP, Gardenghi G, et al. Respiratory muscle training in patients submitted to coronary arterial bypass graft. Braz J Cardiovasc Surg. 2010;25(4):483–490.
    1. Renault JA, Costa-Val R, Rossetti MB. Respiratory physiotherapy in the pulmonary dysfunction after cardiac surgery. Rev Bras Cir Cardiovasc. 2008;23(4):562–569.
    1. Carvalho T, Bonorino KC, Panigas TF. Preoperative respiratory muscle training angiograms complications in coronary artery bypass surgery. Eur Heart J. 2011;32(suppl):328–328.
    1. Hulzebos EH, Helders PJ, Favié NJ, De Bie RA, Brutel de la Riviere A, Van Meeteren NL. Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high-risk patients undergoing CABG surgery: a randomized clinical trial. JAMA. 2006;296(15):1851–1857.
    1. Guedes GP, Barbosa YRA, Holanda G. Correlação entre força muscular respiratória e tempo de internação pós-operatório. Fisioter Mov. 2009;22(4):605–614.
    1. Cavenaghi S, Ferreira LL, Marino LH, Lamari NM. Respiratory physiotherapy in the pre and postoperative myocardial revascularization surgery. Rev Bras Cir Cardiovasc. 2011;26(3):455–461.
    1. Garcia RCP, Costa D. Treinamento muscular respiratório em pós-operatório de cirurgia cardíaca eletiva. Rev Bras Fisioter. 2002;6(3):139–146.
    1. Ferreira PE, Rodrigues AJ, Evora PR. Effects of an inspiratory muscle rehabilitation program in the postoperative period of cardiac surgery. Arq Bras Cardiol. 2009;92(4):275–282.
    1. Mans CM, Reeve JC, Elkins MR. Postoperative outcomes following preoperative inspiratory muscle training in patients undergoing cardiothoracic or upper abdominal surgery: a systematic review and meta analysis. Clin Rehabil. 2015;29(5):426–438.
    1. Nephew MT, Guirado GN, Silva MA. Preoperative therapy restores ventilatory parameters and angiograms length of stay in patients undergoing myocardial revascularization. Rev Bras Cir Cardiovasc. 2014;29(2):221–228.
    1. Matheus GB, Dragosavac D, Trevisan P, Costa CE, Lopes MM, Ribeiro GC. Inspiratory muscle training improves tidal volume and vital capacity after CABG surgery. Rev Bras Cir Cardiovasc. 2012;27(3):362–369.
    1. Nery RM, Martini MR, Vidor CR, Mahmud MI, Zanini M, Loureiro A, et al. Changes in functional capacity of patients two years after coronary artery bypass grafting surgery. Rev Bras Cir Cardiovasc. 2010;25(2):224–228.
    1. Foroncewicz B, Mucha K, Szparaga B, Raczynska J, Ciszek M, Pilecki T, et al. Rehabilitation and 6-minute walk test after liver transplantation. Transplant Proc. 2011;43(8):3021–3024.
    1. Pedrosa R, Holanda G. Correlation between the walk, 2-minute step and TUG tests among hypertensive older women. Rev Bras Fisioter. 2009;13(3):252–256.

Source: PubMed

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