Aerobic exercise applied early on coronary artery bypass grafting patients may promote maintenance of functional capacity, with no impact on pulmonary function and respiratory muscle strength when compared with conventional physiotherapy.
ObjectiveTo apply the InsCor in patients undergoing cardiac surgery in a university hospital in Brazil's northeast.MethodsIt is a retrospective, quantitative and analytical study, carried out at the University Hospital of the Federal University of Maranhão. InsCor is a remodeling of two risk score models. It evaluates the prediction of mortality through variables such as gender, age, type of surgery or reoperation, exams, and preoperative events. Data from January to December 2015 were collected, using a Physical Therapy Evaluation Form and medical records. Quantitative variables were expressed as mean and standard deviation and qualitative variables as absolute and relative frequencies. Fisher's exact and Kruskal-Wallis tests were applied, considering significant differences when P value was < 0.05. Calibration was performed by Hosmer-Lemeshow test.ResultsOne hundred and forty-eight patients were included. Thirty-six percent were female, with mean age of 54.7±15.8 years and mean body mass index (BMI) equal to 25.6 kg/m2. The most frequent surgery was coronary artery bypass grafting (51.3%). According to InsCor, 73.6% of the patients had low risk, 20.3% medium risk, and only 6.1% high risk. In this sample, 11 (7.4%) patients died. The percentage of death in patients classified as low, medium and high risk was 6.3, 7.1% and 11.1%, respectively.ConclusionInsCor presented easy applicability due to the reduced number of variables analyzed and it showed satisfactory prediction of mortality in this sample of cardiac surgery patients.
Background: Cardiac surgery causes pathophysiological changes that favor the occurrence of pulmonary and functional complications.Objective: To investigate the effects of inspiratory muscle training (IMT) with an electronic device on patients undergoing cardiac surgery.Methods: A randomized controlled trial was conducted with 30 adult patients undergoing elective cardiac surgery. A control group (CG) received conventional physical therapy care, and an intervention group (IG) received IMT using the POWERbreathe K5® electronic device. Two daily sessions of physical therapy were performed at the intensive care unit and one daily session at the ward until the sixth postoperative day. The following variables were measured preoperatively and on the sixth postoperative day, in both groups: inspiratory muscle strength, dynamic inspiratory muscle strength, and peak inspiratory flow. Data distribution was evaluated by the Shapiro-Wilk test. Analysis of variance was used, and the results were considered statistically significant when p < 0.05.Results: Maximal inspiratory pressure (71.7 ± 17.1 cmH2O vs 63.3 ± 21.3 cmH2O; p = 0.11], S-index (52.61 ± 18.61 vs 51.08 ± 20.71), and peak inspiratory flow [(2.94 ± 1.09 vs 2.79 ± 1.26)] were maintained in the IG but had a significant reduction in the CG. Conclusion:IMT performed with an electronic device was effective at maintaining inspiratory muscle strength, dynamic inspiratory muscle strength, and peak inspiratory flow when compared to conventional physical therapy.
Introdução: A cirurgia cardíaca é uma intervenção de grandeimportância no tratamento de doenças cardiovasculares, asquais contribuem para o aumento da morbimortalidade. Avibração mecânica gerada por uma plataforma oscilante/vibratória pode ser usada para exercícios de vibração no corpointeiro (EVCI), modalidade de exercício físico aqui proposta.Objetivo: Apresentar protocolo para avaliação de efeitos doEVCI em indivíduos no pós-operatório de cirurgia cardíaca.Métodos: Indivíduos adultos, submetidos a cirurgia cardíaca,que receberem alta da Unidade de Tratamento intensivo atéo quarto dia de pós-operatório, serão distribuídos randomicamenteem 2 grupos: grupo controle (GC), que receberá atendimentofisioterapêutico convencional; e grupo Intervenção(GI), que, além do atendimento convencional, será submetidoao EVCI. Os pacientes do GI permanecerão com os joelhosflexionados a 15° na plataforma osclante/vibratória alternada,realizarão três séries de 1 min (por 1 min de repouso) a 5 Hz e 8mm de deslocamento pico a pico, duas vezes ao dia. A cada dia,as sessões serão modificadas, atingindo o máximo sete séries de1 min e 9 Hz, no sétimo dia de pós-operatório. Serão avaliadas aforça muscular respiratória, função pulmonar, força muscularperiférica, capacidade funcional e sensação de dor através damanovacuometria, espirometria, dinamometria, Time Up andGo (TUG), Medida de Independência Funcional (MIF), EscalaVisual Analógica de Dor (EVA), POWERbreathe K5. Discussão:Estudos recentes demonstraram efeitos benéficos com EVCIem diferentes condições clínicas, que se apresenta como umapromissora forma de intervenção durante a reabilitação nopós-operatório de cirurgia cardíaca. Conclusão: A aplicaçãodesse protocolo de estudo poderá preencher as lacunas sobreevidências que justificam um programa de reabilitação comEVCI para o indivíduo submetido à cirurgia cardíaca.Descritores: Exercício de vibração de corpo inteiro; Terapia porexercício; Unidade de Terapia Intensiva. Cirurgia cardíaca.
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