Evaluation of Inspiratory Muscle Strength Early After Coronary Artery Bypass

Study Overview
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Brief Summary
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The purpose of this study is to evaluate the effects of a 6-day postoperative in hospital cardiopulmonary rehabilitation program on inspiratory muscle strength and its potential association with improved functional capacity after coronary artery bypass grafting surgery.

Detailed Description
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Eligible patients were randomized to a cardiopulmonary rehabilitation program (Rehab; n = 10) or to usual care (Control; n = 10). The randomization was done by the Graphpad StatMate computerized program. Those patients assigned to Control were followed by their own physicians, received routine nursing assistance, were visited daily by the one of the investigators (CPM), but were not exposed to any specific respiratory or motor physical intervention. Those randomized to Rehab received the same medical and nursing care, but followed a structured physical therapy program twice a day.

Official Title
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Inspiratory Muscle Strength as a Determinant of Functional Capacity Early After Coronary Artery Bypass Graft Surgery

Conditions
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Coronary Artery Disease

Intervention / Treatment
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* Other: In Hospital Cardiopulmonary Rehabilitation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Previous history of more than one vessel coronary artery disease Lifelong abstinence from tobacco Formal indication for CABG Exclusion Criteria: Patients older than 75 years of age Chronic renal failure (dialysis for more than 3 months) Unstable angina in the 48 hours prior to CABG Moderate or severe valve disease Complex cardiac arrhythmia's Stroke Inability to exercise the lower limbs Previous pulmonary disease (forced vital capacity [FVC] < 80% of predicted and/or forced expiratory volume in 1 s [FEV1] < 70% of predicted) Previous history of asthma.

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 1<br> | Other: In Hospital Cardiopulmonary Rehabilitation<br>* The program consisted of bronchial hygiene characterized by detachment and removal of secretions and respiratory exercises which were applied in the respiratory muscles in order to strengthen and increase the resistance. Patients were instructed to maintain diaphragmatic breathing, at a rate of 12 to 18 breaths per minute during EPAP mask use, and the expiratory pressure was increased progressively in the following fashion: 3-8 cm H2O during 3-12 minutes. Also, they performed flexion/extension of hip and knee, active free exercises for upper limbs, ambulation exercise and ascent/descend of stairs<br>* Other names: Phase one cardiac rehabilitation;|
| No Intervention: 2<br>Those patients assigned to Control were followed by their own physicians, received routine nursing assistance, were visited daily by the one of the investigators (CPM), but were not exposed to any specific respiratory or motor physical intervention. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Maximal inspiratory and expiratory pressure were measured (before, 7 and 30 days after surgery). |  | From 1 day before surgery up to 30 days after surgery (CABG) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Six-minute walk test (6MWT) was performed 7 days after surgery, and maximal cardiopulmonary exercise testing (CPET) was performed 30 days after CABG. |  | From 7 days after surgery up to 30 days after surgery (CABG) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Physical therapy, Inspiratory muscles, Exercise