Cycle Ergometer Exercise in Phase I of Cardiac Rehabilitation After Cardiac Surgery
2021年1月28日 更新者：Ada Clarice Gastaldi、University of Sao Paulo
The prevalence of heart diseases has increased significantly in recent years and it is a health public problem due to an increased risk of death by several reasons.
A cardiac surgery is an alternative of treatment for critical injuries heart valves and coronaries arteries.
Changes in respiratory system resulting from cardiac surgery are well established and include a reduced functional capacity due post-surgical pain, causing increased respiratory function and increased oxygen consumption .
The exercises with the cycle ergometer in phase I of cardiac rehabilitation can improve peripheral muscle strength, functional capacity and perception of dyspnea when used postoperatively and there are speculations if an earlier carried out can contribute to a better postoperative evolution of patients, but these benefits in phase I of the Rehabilitation Cardiac are not well defined in the literature.
Objective: To evaluate the exercises effects with ergometer cycle in the postoperative course of patients undergoing cardiac surgery.
Method: Patients will be recruited the cardiac surgery service of Polyclinic Pato Branco in the city of Pato Branco in state of Paraná, of both sexes, appropriate for the inclusion criteria, which will be evaluated by pulmonary function tests (strength of respiratory muscles, submaximal exercise test, dyspnea scales, laboratories tests and radiological exam).
All patients will be randomly assigned for one of two groups: the control group (Conventional treatment) and rehabilitation group (conventional treatment +cycle ergometer), for about 7 days at postoperative period.
Patients will be reevaluated on the third postoperative day and at discharge.
Clinical evolution data will be collected from the records and notes of the medical staff and monitoring physiotherapist.
研究概览
详细说明
The research will be a randomized controlled clinical trial.
The study will be conducted at the Polyclinic Pato Branco, in the city of Pato Branco Parana - Brazil and this study already approved by the Ethics Committee Clinical Hospital and Faculty of Medicine, University of São Paulo and all participants sign the consent form informed.
For the implementation of research wil be recruited patients heart surgery who fit the inclusion criteria and do not show any characteristics of the exclusion criteria, which agree to participate and sign the consent form free and informed.
The equipment and tests are already included in routine admissions of patients, approved by the hospital and the Brazilian Public Health System (SUS).
研究类型
介入性
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
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Paraná
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Pato Branco、Paraná、巴西、85501250
- Policlínica Pato Branco
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参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
30年 至 70年 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
Inclusion Criteria:
- Patients undergoing cardiac surgery type Myocardial Revascularization and Exchange Mitral Valve Aortic, both sexes and aged between 30-75 years.
Exclusion Criteria:
Patients undergoing surgical correction of heart disease congenital, aortic aneurysm and dissection of aorta;
- Present disabling disease to accomplish what is proposed in study as previous stroke, mental or motor deficit, hearing loss, amputation of the lower limbs (unilateral or bilateral);
- Present psychomotor agitation of immediate postoperative and first postoperative and history weaning failure in the immediate;
- Instability hemodynamics and vasoactive drugs;
- Present what other type of peri and postoperative complications;
- Re-operation within 24 hrs.
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：单身的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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安慰剂比较：Control group: routine physiotherapy
Are patients who carry out the routine already established the Unit, consisting of the first post surgery, the patient lying down doing the breathing exercises, active exercises ends and active-assisted upper (UL) and lower limbs (LL),
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routine physiotherapy
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有源比较器：Intervention group: ergometer cycle exercise
Are the patients who will carry out the exercises routine over the cycle ergometer twice daily from 3 PO for 5 minutes with its progressiveness at discharge for ward for 10 minutes
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routine physiotherapy
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Change of six-minute walk test (6MMWT) distance
大体时间：Before surgery ,third and seventh postoperative day
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The six-minute walk test will be conducted with monitoring blood pressure, HR, RR and SpO2 in a hall plan, with distances previously marked.
The patient will be accompanied by the researcher and encouraged by constant verbal stimulation, walking as fast as possible, if the patient stop walking the timer will keep triggered.
Will use the oximeter with the sensor on the third finger of the right hand, and a certain reading after the signal stabilization and at the same time we get the heart rate.
Will be used to calculate the expected value, and reference to distance in the 6MWT, the equations proposed by Enright and Sherrill (1998) determining the percentage of predicted for each test performed by patient.
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Before surgery ,third and seventh postoperative day
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Change of spirometric values
大体时间：Before surgery ,third and seventh postoperative day
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Spirometry will be performed according to criteria of the American Thoracic Society and the Brazilian Consensus Spirometry.
Values will be observed from CVF, VEF1 e PEF.
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Before surgery ,third and seventh postoperative day
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Change of respiratory muscle strength - Mouth pressure measurements
大体时间：Before surgery ,third and seventh postoperative day
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Manovacuometry will be performed with the patient seated with nasal clip, the display scale with intervals of 4 cmH2O and variation +/- 120 cmH2O.
The highest value obtained during the two maneuvers will be compared to the table described by Neder et al (1999), which predicts expected values for the Brazilian population according to gender and age.
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Before surgery ,third and seventh postoperative day
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Change of perceived dyspnea
大体时间：Before surgery ,third and seventh postoperative day
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The perceived effort is used the Borg Scale modified scored from 0 to 10.
And dyspnea scale will be scored from 0 to 4 according to the intensity of dyspnea and is based on used the scale of the Medical Research Council (MRC).
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Before surgery ,third and seventh postoperative day
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Change of body mass index
大体时间：Before surgery and postoperative seventh day
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The BMI will be calculated using the classical formula: BMI = current weight (kg) / A2 (m).
The following lower limits of normal were considered: BMI <21 for age group 35-44 years; <22 for 45-54 years; <23 for 55 -64 years and <24 to 65 above years.
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Before surgery and postoperative seventh day
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Change of cirtometry
大体时间：Before surgery ,third and seventh posoperative day
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Cirtometry will be held in myocardial revascularization of patients who use the saphenous and waist hip will be performed in all patients.
Will be used a tape measure.
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Before surgery ,third and seventh posoperative day
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Change of peripheral muscle strength
大体时间：Before surgery ,third and seventh postoperative day
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The peripheral muscle strength assessment test will be the end of the test the foot, the patient will be instructed to stay barefoot with his right hand resting on the front wall and with a semi elbow flexion to aid maintenance balance.
Prior to testing, the participant will be oriented make a plantar flexion to the point of support of the joints metatarsophalangeal and this time will be marked by the examiner through a mark on the wall and the patient will be informed that should reach the one marked point.
The test itself consisted of time, in seconds, the time it takes to perform five push-ups as plantar soon as possible.
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Before surgery ,third and seventh postoperative day
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Change in cortisol levels
大体时间：Before surgery ,third and seventh postoperative day
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Laboratory evaluation will be performed by laboratory staff of hospital with a blood sample from the patient, which will be assessed the cortisol levels .
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Before surgery ,third and seventh postoperative day
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change of radiological assessment
大体时间：Before surgery ,third and seventh postoperative day
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Radiological assessment will be held the day before the surgery, the third post-operative and post-operative seventh, the clinic Radiology Southwest - Pato Branco - Paraná to assess complications lung from surgery.
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Before surgery ,third and seventh postoperative day
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Adherence evaluation
大体时间：Third and seventh postoperative day
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The questionnaire will be administered at the end of the first contact of the patient the exercises with the cycle ergometer to assess adherence running a differential exercise during your surgical recovery.
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Third and seventh postoperative day
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
初级完成 (实际的)
2021年1月28日
研究注册日期
首次提交
2015年4月29日
首先提交符合 QC 标准的
2015年5月6日
首次发布 (估计)
2015年5月7日
研究记录更新
最后更新发布 (实际的)
2021年2月2日
上次提交的符合 QC 标准的更新
2021年1月28日
最后验证
2021年1月1日
更多信息
与本研究相关的术语
其他研究编号
- USP 2015-1
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.
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