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da Silva LG, Magnaguagno DM, da Silva MMD, Borghi-Silva A, Winkelmann ER. Functional Physical Analysis and Quality of Life in the Preoperative and Early Postoperative Periods of Cardiac Surgery and 30 Days After Hospital Discharge. Braz J Cardiovasc Surg 2024; 39:e20220453. [PMID: 38748911 PMCID: PMC11095118 DOI: 10.21470/1678-9741-2022-0453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/17/2023] [Indexed: 05/19/2024] Open
Abstract
INTRODUCTION The analysis of patients submitted to heart surgery at three assessment times has been insufficiently described in the literature. OBJECTIVE To analyze chest expansion, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), distance traveled on the six-minute walk test (6MWT), and quality of life in the preoperative period, fourth postoperative day (4th PO), and 30th day after hospital discharge (30th-day HD) in individuals submitted to elective heart surgery. METHODS A descriptive, analytical, cross-sectional study was conducted with 15 individuals submitted to elective heart surgery between 2016 and 2020 who did not undergo any type of physiotherapeutic intervention in Phase II of cardiac rehabilitation. The outcome variables were difference in chest expansion (axillary, nipple, and xiphoid), MIP, MEP, distance on 6MWT, and quality of life. The assessment times were preoperative period, 4th PO, and 30th-day HD. RESULTS Chest expansion diminished between the preoperative period and 4th PO, followed by an increase at 30th-day HD. MIP, MEP, and distance traveled on the 6MWT diminished between the preoperative period and 4th PO, with a return to preoperative values at 30th-day HD. General quality of life improved between the preoperative period and 4th PO and 30th-day HD. An improvement was found in the social domain between the preoperative period and the 30th-day HD. CONCLUSION Heart surgery causes immediate physical deficit, but physical functioning can be recovered 30 days after hospital discharge, resulting in an improvement in quality of life one month after surgery.
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Affiliation(s)
- Luana Gehm da Silva
- Graduate Program in Health Promotion, Universidade de Santa Cruz do
Sul, Santa Cruz, Rio Grande do Sul, Brazil
| | - Danieli Maria Magnaguagno
- Undergraduate in Physiotherapy, Universidade Regional do Noroeste
do Estado do Rio Grande do Sul, Ijuí, Rio Grande do Sul, Brazil
| | - Mariana Motta Dias da Silva
- Graduate Program in Statistics, Universidade Federal do Rio Grande
do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Audrey Borghi-Silva
- Graduate Program in Physical Therapy (PPGFt), Universidade Federal
de São Carlos, São Carlos, São Paulo, Brazil
| | - Eliane Roseli Winkelmann
- Graduate Program in Comprehensive Health Care (PPGAIS) (UNICRUZ,
UNIJUI, URI), Universidade Regional do Noroeste do Estado do Rio Grande do Sul,
Ijuí, Rio Grande do Sul, Brazil
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Souza AV, da Cunha Carvalho R, da Cruz Dias D, Santana DGT, de Cássia Mascarenhas H, Cordeiro ALL, Guimarães ARF. Clinical and functional outcomes associated with pulmonary complications after coronary artery bypass grafting. J Cardiothorac Surg 2024; 19:92. [PMID: 38355549 PMCID: PMC10865619 DOI: 10.1186/s13019-024-02538-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 01/28/2024] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION Coronary artery bypass grafting(CABG) is a surgical treatment for coronary artery disease aiming at improving symptoms and life expectancy. Despite this, there are pulmonary and functional complications that may arise during the postoperative period due to invasive mechanical ventilation(IMV), cardiopulmonary bypass and immobility, leading to longer hospital stays. OBJECTIVE To evaluate the clinical and functional outcomes related to pulmonary complications in the postoperative period of CABG. METHODS Prospective cohort. During the ICU stay the patients were divided into: Non Complicated Group(NCG) who did not present complications and Complicated Group(CG) who presented complication. Functional variables were applied as the six-minute walk test(6MWT), gait speed, sit up and stand up test, Timed Up and Go, peripheral muscle strength, ventilatory, pulmonary function and Functional Independence Measure. These tests were applied preoperatively, at ICU discharge, hospital discharge and six months after surgery. RESULTS The study evaluated 90 patients, 59 in the NCG and 31 CG. In the 6MWT there was a 2%(p = 0.43) decrease in the NCG, while the decrease was 13%(p < 0.01) in the CG. In the MRC the drop was 2%(p = < 0.01) in the CNG, while in the CG the drop was 14%(p = < 0.01). In MIP the NCG had a 6%(p = 0.67) decrease, while the CG had a 16%(p = < 0.01) decrease. CONCLUSION Patients with postoperative complications of CABG may have reduced functional performance, muscle strength, and pulmonary function at hospital discharge and after six months.
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Affiliation(s)
- Altina Vitória Souza
- Centro Universitário Nobre, Red Bird Street, without number, Condominio Salvador Dali, house 47, Feira de Santana, BA, Brazil
| | - Raquel da Cunha Carvalho
- Centro Universitário Nobre, Red Bird Street, without number, Condominio Salvador Dali, house 47, Feira de Santana, BA, Brazil
| | - Daniela da Cruz Dias
- Centro Universitário Nobre, Red Bird Street, without number, Condominio Salvador Dali, house 47, Feira de Santana, BA, Brazil
| | - Darley Gabrielle Teles Santana
- Centro Universitário Nobre, Red Bird Street, without number, Condominio Salvador Dali, house 47, Feira de Santana, BA, Brazil
| | - Hayssa de Cássia Mascarenhas
- Centro Universitário Nobre, Red Bird Street, without number, Condominio Salvador Dali, house 47, Feira de Santana, BA, Brazil
| | - André Luiz Lisboa Cordeiro
- Centro Universitário Nobre, Red Bird Street, without number, Condominio Salvador Dali, house 47, Feira de Santana, BA, Brazil.
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil.
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Thanasarn B, Pibul W, Kulchanarat C, Piathip D, Yuenyongchaiwat K. A Prospective Study of 73 Patients to Compare Forward Head Angle, Forward Shoulder Angle, Maximal Inspiratory Pressure, and Self-Reported Breathing-Related Symptoms Before and After Open-Heart Surgery. Med Sci Monit Basic Res 2023; 29:e938802. [PMID: 36849799 PMCID: PMC9921079 DOI: 10.12659/msmbr.938802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Patients who undergo open-heart surgery often experience widespread musculoskeletal and pulmonary complications. These can interfere with their functioning, resulting in soft tissue changes, worsening postural changes, and poor respiratory performance. Therefore, the prospective study aimed to compare forward head angle (FHA) and forward shoulder angle (FSA), maximal inspiratory pressure (MIP), and self-reported breathing dysfunction before and after open-heart surgery. MATERIAL AND METHODS In a prospective observational study of 106 patients, men and women scheduled for open-heart surgery were enrolled. Prior to surgery and before discharge from the hospital, all patients were required to assess FHA and FSA using 2-dimensional motion analysis software, MIP using a respiratory pressure meter, and breathing dysfunction using the 25-item Self Evaluation of Breathing Questionnaire (SEBQ). Paired t test was used to compare differences between before and after surgery. To evaluate associations, logistic regression analysis was performed. RESULTS Of the 106 patients recruited, 73 completed the study. FHA (-Δ6.55±4.77, P.
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Affiliation(s)
- Bussakorn Thanasarn
- Department of Physiotherapy, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand,Department of Rehabilitation Medicine, Rajavithi Hospital, Bangkok, Thailand
| | - Wittawat Pibul
- Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
| | - Chitima Kulchanarat
- Center of Physical Therapy, Thammasat Medical Hospital, Pathumthani, Thailand
| | - Dusarkorn Piathip
- Cardiovascular Thoracic Surgery (CVT) Unit, Thammasat Medical Hospital, Pathumthani, Thailand
| | - Kornanong Yuenyongchaiwat
- Department of Physiotherapy, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand,Thammasat University Research Unit in Physical Therapy in Cardiovascular and Respiratory Systems, Thammasat University, Pathumthani, Thailand
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Yang MX, Wang J, Zhang X, Luo ZR, Yu PM. Perioperative respiratory muscle training improves respiratory muscle strength and physical activity of patients receiving lung surgery: A meta-analysis. World J Clin Cases 2022; 10:4119-4130. [PMID: 35665118 PMCID: PMC9131220 DOI: 10.12998/wjcc.v10.i13.4119] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/07/2022] [Accepted: 03/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The clinical role of perioperative respiratory muscle training (RMT), including inspiratory muscle training (IMT) and expiratory muscle training (EMT) in patients undergoing pulmonary surgery remains unclear up to now.
AIM To evaluate whether perioperative RMT is effective in improving postoperative outcomes such as the respiratory muscle strength and physical activity level of patients receiving lung surgery.
METHODS The PubMed, EMBASE (via OVID), Web of Science, Cochrane Library and Physiotherapy Evidence Database (PEDro) were systematically searched to obtain eligible randomized controlled trials (RCTs). Primary outcome was postoperative respiratory muscle strength expressed as the maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). Secondary outcomes were physical activity, exercise capacity, including the 6-min walking distance and peak oxygen consumption during the cardio-pulmonary exercise test, pulmonary function and the quality of life.
RESULTS Seven studies involving 240 participants were included in this systematic review and meta-analysis. Among them, four studies focused on IMT and the other three studies focused on RMT, one of which included IMT, EMT and also combined RMT (IMT-EMT-RMT). Three studies applied the intervention postoperative, one study preoperative and the other three studies included both pre- and postoperative training. For primary outcomes, the pooled results indicated that perioperative RMT improved the postoperative MIP (mean = 8.13 cmH2O, 95%CI: 1.31 to 14.95, P = 0.02) and tended to increase MEP (mean = 13.51 cmH2O, 95%CI: -4.47 to 31.48, P = 0.14). For secondary outcomes, perioperative RMT enhanced postoperative physical activity significantly (P = 0.006) and a trend of improved postoperative pulmonary function was observed.
CONCLUSION Perioperative RMT enhanced postoperative respiratory muscle strength and physical activity level of patients receiving lung surgery. However, RCTs with large samples are needed to evaluate effects of perioperative RMT on postoperative outcomes in patients undergoing lung surgery.
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Affiliation(s)
- Meng-Xuan Yang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jiao Wang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xiu Zhang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ze-Ruxin Luo
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Peng-Ming Yu
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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de Andrade ÉV, Haas VJ, de Faria MF, dos Santos Felix MM, Ferreira MBG, Barichello E, da Silva Pires P, Barbosa MH. Effect of listening to music on anxiety, pain, and cardiorespiratory parameters in cardiac surgery: study protocol for a randomized clinical trial. Trials 2022; 23:278. [PMID: 35410256 PMCID: PMC8996225 DOI: 10.1186/s13063-022-06233-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 03/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Preoperative anxiety and postoperative pain are frequent in cardiac surgeries and constitute important stressors for patients, which can cause several complications. One strategy that aims to alleviate these phenomena is listening to music as a non-pharmacological intervention. The aim of this study is to evaluate the effect of listening to music on preoperative state-anxiety, postoperative pain, at rest and when instructed to cough, and cardiorespiratory parameters in patients undergoing cardiac surgery. Methods A randomized, parallel, simple masking clinical trial will be conducted with patients 18 years of age or older who have undergone elective cardiac surgery by sternotomy, who agree to participate in the research and sign a free and informed consent form. Study participants will be randomly divided, in a 1:1 ratio, to one of the two groups: experimental (subjected to listening to music for 20 min in the pre- and postoperative period) or control (standard care in the pre- and postoperative period), using a randomization scheme generated by the Randomization.com website. The sample size calculation was obtained after conducting a pilot study. Discussion The results of the study may contribute to the implementation of non-pharmacological interventions in health services, highlighting the protocols for listening to music, to minimize anxiety and pain in cardiac surgery. Trial registration ReBEC RBR-8mdyhd. Posted on December 10, 2019 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06233-9.
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Dsouza FV, Amaravadi SK, Samuel SR, Raghavan H, Ravishankar N. Effectiveness of Inspiratory Muscle Training on Respiratory Muscle Strength in Patients Undergoing Cardiac Surgeries: A Systematic Review With Meta-Analysis. Ann Rehabil Med 2021; 45:264-273. [PMID: 34496469 PMCID: PMC8435466 DOI: 10.5535/arm.21027] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/17/2021] [Indexed: 01/04/2023] Open
Abstract
To determine the effect of inspiratory muscle training (IMT) on pulmonary function, respiratory muscle strength (RMS), and functional capacity in patients undergoing cardiac surgery. The PubMed, PEDro, CINAHL, Web of Science, CENTRAL, and EMBASE databases were searched from inception to June 2020. Randomized controlled trials (RCTs) that evaluated patients who underwent cardiac surgery were included in this review. Meta-analysis performed using a random-effects model showed that the mean difference in forced vital capacity, forced expiratory volume in 1 second, 6-minute walk distance, and RMS was 3.47% (95% confidence interval [CI], 0.57 to 6.36), 5.80% (95% CI, 2.03 to 9.56), 78.05 m (95% CI, 60.92 to 95.18), and 4.8 cmH2O (95% CI, -4.00 to 13.4), respectively. There is strong evidence that IMT improves inspiratory muscle strength, pulmonary function, and functional capacity, and reduces the length of hospital stay in patients undergoing cardiac surgery.
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Affiliation(s)
- Fiona Verdine Dsouza
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sampath Kumar Amaravadi
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.,Department of Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates
| | - Stephen Rajan Samuel
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Harish Raghavan
- Department of Cardiothoracic Surgery, Kasturba Medical Hospital, Mangalore, Karnataka, India
| | - Nagaraja Ravishankar
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, India
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Tosta ADM, Borges MDC, Silva ÉMCD, Silva AAD, Crema E. Pre- and postoperative respiratory muscle strength, body mass index and fasting glucose profile of patients with type 2 diabetes mellitus submitted to metabolic surgery. FISIOTERAPIA EM MOVIMENTO 2020. [DOI: 10.1590/1980-5918.033.ao51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: The lung is considered a target organ in diabetes mellitus as a consequence of alterations secondary to chronic hyperglycemia that compromise respiratory muscle strength. Metabolic surgery for improving diabetes mellitus has beneficial effects on weight loss and glucose metabolism. Objective: The objective of this study was to evaluate the respiratory muscle strength, assessed by MIP and MEP, body mass index (BMI) and fasting glucose profile of patients with type 2 diabetes mellitus before and after metabolic surgery without gastric resection. Method: Seventeen patients with type 2 diabetes mellitus participated in the study. The participants had a mean age of 44.8 ± 11.81 years. Results: The results showed a significant decrease of MEP values in the immediate postoperative period when compared to the preoperative period (p=0.001), while no significant results were obtained for MIP. Regarding BMI and fasting glucose, significant weight loss and a significant reduction in fasting glucose levels were observed in the late postoperative period (p=0.006 and p=0.007, respectively). Conclusion: The MIP and MEP were reestablished and satisfactory results were obtained for BMI and fasting glucose in the late postoperative period. Further studies are needed to monitor patients in the pre- and postoperative period of metabolic surgery, identifying complications and acting on the care and recovery of these patients.
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