COMPARISON OF THE EFFECT OF INCENTIVE SPIROMETRY AND INSPIRATORY MUSCLE TRAINING ON THE RESTORATION OF PULMONARY FUNCTION AFTER CARDIAC SURGERY
DOI:
https://doi.org/10.32782/2077-6594.2.1.2021.235372Keywords:
cardiorehabilitation, physical rehabilitation, therapeutic exercises, respiratory systemAbstract
Purpose: to compare the effect of flow-oriented incentive spirometry (IS) and inspiratory muscle training (IMT) on spirography parameters among cardiac surgery patients.
Materials and methods. The study involved 90 patients who underwent cardiac surgery. Patients were randomly assigned to the ІS group and the IMT group (1:1 ratio). Patients received the same physical therapy in terms of early mobilization, therapeutic exercises, walking, coughing. The groups differed in respiratory physical therapy: ІМТ group – breathing exercises with Respironics Threshold IMT; group SS – simulator Tri-Ball. Before surgery and on the 7th postoperative day (PОD), patients of all groups underwent spirography.
Results. The statistical analysis did not confirm the benefits of any of the used respiratory techniques of physical therapy. The initial values of vital capacity of the lungs were 104.29±14.06% in the ІS group and 104.91±19.42% in the IMT group (p=0.853), and after surgery were 74.93±16.90% and 77,84±14.68%, respectively (p=0.385). Lung vital capacity decreased by 29.36% in the CC group and 27.07% in the IMT group. The dynamics of forced vital capacity of the lungs was 27.69% and 26.27%, respectively.
Conclusions. No differences between the effect of ІS and ІМТ on pulmonary function in cardiac surgery patients were found.
References
Vitomskiy V, Hruzevych I, Salnykova S, Sulyma A, Kormiltsev V, Kyrychenko Y, et al. The physical development of children who have a functionally single heart ventricle as a basis for working physical rehabilitation technology after a hemodynamic correction. JPES. 2019;18(2):614-7.
Balazh M, Kormiltsev V, Kostenko V, Vitomskyi, V., Strohanov, S., Sabadosh, et al. Physical rehabilitation program of patients with ischemic heart disease with metabolic syndrome. JPES. 2020;20(6):3528-35.
Guizilini S, Gomes WJ, Faresin SM, Carvalho ACC, Jaramillo JI, Alves FA, et al. Efeitos do local de inserção do dreno pleural na função pulmonar no pós-operatório de cirurgia de revascularização do miocárdio. Brazilian Journal of Cardiovascular Surgery. 2004;19(1):47-54.
Barbosa RAG, Carmona MJC. Avaliação da função pulmonar em pacientes submetidos à cirurgia cardíaca com circulação extracorpórea. Revista brasileira de anestesiologia. 2002;52(6):689-99.
Vitomskyi V. The impact of mobilization and other factors on pleural effusion in patients undergoing cardiac surgical procedures. JPES. 2020;20 (Suppl. Is. 3):2167-73.
Oikkonen M, Karjalainen K, Kähärä V, Kuosa R, Schavikin L. Comparison of incentive spirometry and intermittent positive pressure breathing after coronary artery bypass graft. Chest. 1991;99(1):60-5.
Elias DG, Costa D, Oishi J, Pires VA, Silva MAM. Efeitos do treinamento muscular respiratório no pré e pós-operatório de cirurgia cardíaca. Rev. bras. ter. Intensiva. 2000;12(1):9-18.
Urell C, Emtner M, Hedenstrom H, Westerdahl E. Respiratory muscle strength is not decreased in patients undergoing cardiac surgery. Journal of cardiothoracic surgery. 2016;11(1):41.
Stein R, Maia CP, Silveira AD, Chiappa GR, Myers J, Ribeiro JP. Inspiratory muscle strength as a determinant of functional capacity early after coronary artery bypass graft surgery. Archives of physical medicine and rehabilitation. 2009; 90(10): 1685-91.
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), 1-7.
Westerdahl E, Olsén MF. Chest physiotherapy and breathing exercises for cardiac surgery patients in Sweden-a national survey of practice. Monaldi Archives for Chest Disease. 2011; 75(2):112-9.
Jenkins SC, Soutar SA, Loukota JM, Johnson LC, Moxham J. A comparison of breathing exercises, incentive spirometry and mobilisation after coronary artery surgery. Physiotherapy Theory and Practice. 1990; 6(3): 117-26.
Dull JL, Dull WL. Are maximal inspiratory breathing exercises or incentive spirometry better than early mobilization after cardiopulmonary bypass?. Physical Therapy. 1983;63(5):655-9.
Westerdahl E, Lindmark B, Almgren SO, Tenling A. Chest physiotherapy after coronary artery bypass graft surgery-a comparison of three different deep breathing techniques. Journal of rehabilitation medicine. 2001;33(2):79-84.
Cargnin C, Karsten M, da Costa Guaragna JCV, Dal Lago P. 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. 2019;39(5):E1-E7.
Savci S, Degirmenci B, Saglam M, Arikan H, Inal-Ince D, Turan HN, et al. (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.
Vitomskyi V, Al-Hawamdeh K, Lazarіeva О, Vitomskа M. The efficacy of using Tri-Ball breathing exerciser in respiratory function recovery of the patients undergoing cardiac surgery. Journal of Human Sport and Exercise. 2022;17(2): in press (online first – September 28, 2020). DOI: https://doi.org/10.14198/jhse.2022.172.09.
Cordeiro ALL, Melo TAD, Neves D, Luna J, Esquivel MS, Guimarães ARF, et al. Inspiratory muscle training and functional capacity in patients undergoing cardiac surgery. Brazilian journal of cardiovascular surgery. 2016;31(2):140-4.
Matheus GB, Dragosavac D, Trevisan P, Costa CE, Lopes MM, et al. Inspiratory muscle training improves tidal volume and vital capacity after CABG surgery. Brazilian Journal of Cardiovascular Surgery. 2012;27(3):362-9.
Johnson D, Hurst T, Thomson D, Mycyk T, Burbridge B, To T, et al. Respiratory function after cardiac surgery. Journal of cardiothoracic and vascular anesthesia. 1996;10(5):571-7.
Taşkin H, Telli Atalay O, Yuncu G, Taşpinar B, Yalman A, Şenol H. Postoperative respiratory muscle training in addition to chest physiotherapy after pulmonary resection: A randomized controlled study. Physiotherapy Theory and Practice. 2020;36(3):378-85.
