Comparison of three respiratory physical therapy techniques and their impact on pulmonary function restoration among cardiac surgery patients in hospital settings
DOI:
https://doi.org/10.14739/2310-1210.2021.4.226538Keywords:
physical therapy, incentive spirometry, іnspiratory muscle training, cardiac rehabilitationAbstract
The aim. To compare three respiratory physical therapy techniques and their impact on pulmonary function restoration among cardiac surgery patients in hospital settings.
Materials and methods. The study involved 126 patients of both sexes who were admitted for cardiac surgery. All the procedures were performed by sternotomy with cardiopulmonary bypass and cardioplegic arrest. The patients were randomly divided (with a ratio of 1:1:1 by envelope method) into the control group (CG, n = 42), incentive spirometry group (ISG, n = 42) and іnspiratory muscle training group (IMTG, n = 42). The examined patients underwent standardized physical therapy (early mobilization; therapeutic exercises; coughing). The groups varied in respiratory therapy. Patients of the ISG group performed additional respiratory exercises using a Tri-Ball respiratory exerciser (three repetitions of 10 forced, full and rapid inspirations through the respiratory exerciser under the supervision of a physical therapist; besides, they were recommended to perform 3 repetitions with 10 inspirations each hour). Patients of the IMTG group performed additional respiratory exercises using Respironics Threshold IMT breathing exerciser, received explanations and recommendations like patients of the ISG group. The pulmonary function test (PFT) was performed for the patients of all groups before the surgery and on the 7 postoperative day.
Results. PFT scores did not differ statistically between the groups of patients before the surgery. The three groups of patients had a negative dynamic of all test indicators, except Tiffeneau index. The analysis of PFT final scores did not confirm a significant difference in the studied indicators among the groups: vital capacity (P = 0.599), forced vital capacity (P = 0.393), forced expiratory volume in one second (P = 0.589), peak expiratory flow (P = 0.326), forced inspiratory vital capacity (P = 0.258), peak inspiratory flow (P = 0.569).
Conclusions. Statistical analysis of PFT indicators did not reveal any significant differences among the groups of cardiac surgery patients at the preoperative examination and on the 7 postoperative day, despite the differences in postoperative respiratory physical therapy.
References
Balazh, M., Kormiltsev, V., Kostenko, V., Vitomskyi, V., Strohanov, S., Sabadosh, M., Yurchenko, O., & Martseniuk, I. (2020). Physical rehabilitation program of patients with ischemic heart disease with metabolic syndrome. Journal of Physical Education and Sport, 20(6), 3528-3535. https://doi.org/10.7752/jpes.2020.06476
Vitomskiy, V., Hruzevych, I., Salnykova, S., Sulyma, A., Kormiltsev, V., Kyrychenko, Y., & Sarafinjuk, L. (2018). The physical development of children who have a functionally single heart ventricle as a basis for working physical rehabilitation technology after a hemodynamic correction. Journal of Physical Education and Sport, 18(2), 614-617. https://doi.org/10.7752/jpes.2018.02089
Guizilini, S., Gomes, W. J., Faresin, S. M., Carvalho, A. C. C., Jaramillo, J. I., Alves, F. A., Catani, R., & Buffolo, E. (2004). Efeitos do local de inserção do dreno pleural na função pulmonar no pós-operatório de cirurgia de revascularização do miocárdio. Revista Brasileira de Cirurgia Cardiovascular, 19(1), 47-54. https://doi.org/10.1590/s0102-76382004000100010
Vitomskyi, V., Al-Hawamdeh, K., Vitomska, M., Lazarіeva, O., & Haidai, O. (2021). The effect of incentive spirometry on pulmonary function recovery and satisfaction with physical therapy of cardiac surgery patients. Advances in Rehabilitation, 35(1), 9-16. https://doi.org/10.5114/areh.2020.102020
Oikkonen, M., Karjalainen, K., Kähärä, V., Kuosa, R., & Schavikin, L. (1991). Comparison of Incentive Spirometry and Intermittent Positive Pressure Breathing after Coronary Artery Bypass Graft. Chest, 99(1), 60-65. https://doi.org/10.1378/chest.99.1.60
Barbosa, R. A., & Carmona, M. J. (2002). Avaliação da função pulmonar em pacientes submetidos à cirurgia cardíaca com circulação extracorpórea. Revista brasileira de anestesiologia, 52(6), 689-699. https://doi.org/10.1590/s0034-70942002000600005
Elias, D. G., Costa, D., Oishi, J., Pires, V. A., & Silva, M. A. M. (2000). Efeitos do treinamento muscular respiratorio no pre e pos-operatorio de cirurgia cardiaca. Revista Brasileira de Terapia Intensiva, 12(1), 9-18. https://pesquisa.bvsalud.org/portal/resource/pt/lil-283770
Vitomskyi, V. (2020). The impact of mobilization and other factors on pleural effusion in patients undergoing cardiac surgical procedures. Journal of Physical Education and Sport, 20(Suppl. 3), 2167-2173. https://doi.org/10.7752/jpes.2020.s3291
Taşkin, H., Telli Atalay, O., Yuncu, G., Taşpinar, B., Yalman, A., & Şenol, H. (2020). Postoperative respiratory muscle training in addition to chest physiotherapy after pulmonary resection: A randomized controlled study. Physiotherapy Theory and Practice, 36(3), 378-385. https://doi.org/10.1080/09593985.2018.1488189
Urell, C., Emtner, M., Hedenstrom, H., & Westerdahl, E. (2016). Respiratory muscle strength is not decreased in patients undergoing cardiac surgery. Journal of Cardiothoracic Surgery, 11(1), Article 41. https://doi.org/10.1186/s13019-016-0433-z
Stein, R., Maia, C. P., Silveira, A. D., Chiappa, G. R., Myers, J., & Ribeiro, J. P. (2009). Inspiratory Muscle Strength as a Determinant of Functional Capacity Early After Coronary Artery Bypass Graft Surgery. Archives of Physical Medicine and Rehabilitation, 90(10), 1685-1691. https://doi.org/10.1016/j.apmr.2009.05.010
Westerdahl, E., & Möller, M. (2010). Physiotherapy-supervised mobilization and exercise following cardiac surgery: a national questionnaire survey in Sweden. Journal of Cardiothoracic Surgery, 5(1), Article 67. https://doi.org/10.1186/1749-8090-5-67
Lomi, C., & Westerdahl, E. (2013). Physical Therapy Treatment after Cardiac Surgery: A National Survey of Practice in Greece. Journal of Clinical & Experimental Cardiology, S7, Article 004. https://doi.org/10.4172/2155-9880.S7-004
Westerdahl, E., & Olsén, M. F. (2011). Chest physiotherapy and breathing exercises for cardiac surgery patients in Sweden - A National survey of practice. Monaldi archives for chest disease, 75(2), 112-119. https://doi.org/10.4081/monaldi.2011.223
Dull, J. L., & Dull, W. L. (1983). Are Maximal Inspiratory Breathing Exercises or Incentive Spirometry Better Than Early Mobilization After Cardiopulmonary Bypass? Physical Therapy, 63(5), 655-659. https://doi.org/10.1093/ptj/63.5.655
Jenkins, S. C., Soutar, S. A., Loukota, J. M., Johnson, L. C., & Moxham, J. (1990). A comparison of breathing exercises, incentive spirometry and mobilisation after coronary artery surgery. Physiotherapy Theory and Practice, 6(3), 117-126. https://doi.org/10.3109/09593989009037789
Westerdahl, E., Lindmark, B., Almgren, S. O., & Tenling, A. (2001). Chest physiotherapy after coronary artery bypass graft surgery - a comparison of three different deep breathing techniques. Journal of Rehabilitation Medicine, 33(2), 79-84. https://doi.org/10.1080/165019701750098920
Cargnin, C., Karsten, M., Guaragna, J., & Dal Lago, P. (2019). Inspiratory Muscle Training After Heart Valve Replacement Surgery Improves Inspiratory Muscle Strength, Lung Function, and Functional Capacity: A RANDOMIZED CONTROLLED TRIAL. Journal of Cardiopulmonary Rehabilitation and Prevention, 39(5), E1–E7. https://doi.org/10.1097/HCR.0000000000000409
Savci, S., Degirmenci, B., Saglam, M., Arikan, H., Inal-Ince, D., Turan, H. N., & Demircin, M. (2011). Short-term effects of inspiratory muscle training in coronary artery bypass graft surgery: A randomized controlled trial. Scandinavian Cardiovascular Journal, 45(5), 286-293. https://doi.org/10.3109/14017431.2011.595820
Cordeiro, A. L., de Melo, T. A., Neves, D., Luna, J., Esquivel, M. S., Guimarães, A. R., Borges, D. L., & Petto, J. (2016). Inspiratory Muscle Training and Functional Capacity in Patients Undergoing Cardiac Surgery. Brazilian Journal of Cardiovascular Surgery, 31(2), 140-144. https://doi.org/10.5935/1678-9741.20160035
Matheus, G. B., Dragosavac, D., Trevisan, P., Costa, C. E., Lopes, M. M., & Ribeiro, G. C. (2012). Inspiratory muscle training improves tidal volume and vital capacity after CABG surgery. Revista Brasileira de Cirurgia Cardiovascular, 27(3), 362-369. https://doi.org/10.5935/1678-9741.20120063
Johnson D., Hurst, T., Thomson, D., Mycyk, T., Burbridge, B., To, T., & Mayers, I. (1996). Respiratory function after cardiac surgery. Journal of Cardiothoracic and Vascular Anesthesia, 10(5), 571-577. https://doi.org/10.1016/s1053-0770(96)80130-3
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)