Effects of Physical Therapy on Cardiac Surgery
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Purpose
Background: Although respiratory physiotherapy has been used in patients undergoing cardiac surgery, evidence lacks concerning its effectiveness. The aim of this study was to evaluate the efficacy of three physiotherapeutic protocols used to recover respiratory volumes in the postoperative period.
Methods: Thirty five patients were randomly allocated into three groups. Exercise group (E) was oriented to progressive mobilization. Incentive Spirometry group (IS) performed deep breathings using VoldyneTM, while Breath-Stacking group (BS) performed successive inspiratory efforts using a facial mask adapted to an unidirectional valve. Both BS and IS also performed progressive mobilization. Forced spirometry was carried out in the pre-operative period and from the first to the fifth postoperative day. Statistical analysis used student t-test and ANOVA, and the differences were considered significant when p<0.05.
| Condition | Intervention |
|---|---|
|
Pulmonary Volumes After Cardiac Surgery |
Device: Incentive Spirometry Device: Breath-Stacking Technique Other: Exercise |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Effects of Physical Therapy on Pulmonary Volumes |
- Respiratory volume [ Time Frame: First five postoperative days ] [ Designated as safety issue: Yes ]
| Enrollment: | 35 |
| Study Start Date: | November 2007 |
| Study Completion Date: | November 2009 |
| Primary Completion Date: | July 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Incentive Spirometry
Incentive Spirometry group (IS) was oriented to take a deep breathing through Voldyne 5000TM (Sherwood Medical; St Loius, MO, USA) from Functional Residual Capacity (FRC) to Total Lung Capacity (TLC).
|
Device: Incentive Spirometry
Incentive Spirometry (IS) has been used extensively in postoperative period and consists of spontaneous deep breaths through a device which provides a visual feedback to maintain a maximum insuflation
Other Name: Voldyne
|
|
Active Comparator: Exercise group
Patients were taught huffing (forced expiration while the glottis is opened), supported cough (with patient's hands placed on the sternotomy incision) and mobilization, including active limb exercises, sit out of bed and deambulation (starting on the third postoperative day).
|
Other: Exercise
Patients were taught huffing (forced expiration while the glottis is opened), supported cough (with patient's hands placed on the sternotomy incision) and mobilization, including active limb exercises, sit out of bed and deambulation (starting on the third postoperative day).
Other Name: Early mobilization
|
|
Active Comparator: Breath-Stacking
Breath-Stacking group (BS) performed successive inspiratory efforts using a facial mask adapted to an unidirectional valve
|
Device: Breath-Stacking Technique
An one-way valve device to promote the summation of successive inspiratory volumes while expiration was avoided
Other Name: One-way inspiratory valve
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Patients were not included if any of the following criteria was present:
- Informed consent could not be obtained
- Could not perform the preoperative tests
- Cognitive impairments to perform the IS
- Intolerance to the use of BS mask
Exclusion Criteria:
Exclusion criteria included:
- Hemodynamic complications (intraoperative myocardial infarction
- Major blood loss
- Marked hypotension
- Reduced cardiac output requiring the use of an intra-aortic balloon pump or extraordinary use of medications) and intubation period longer than 72 hours following arrival in the intensive care unit
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Cristina Márcia Dias, Centro Universitário Augusto Motta |
| ClinicalTrials.gov Identifier: | NCT01074957 History of Changes |
| Other Study ID Numbers: | UNISUAM, Mestrado UNISUAM |
| Study First Received: | February 22, 2010 |
| Last Updated: | February 23, 2010 |
| Health Authority: | Brazil: National Committee of Ethics in Research |
ClinicalTrials.gov processed this record on May 23, 2013