Introduction:The assessment of patient satisfaction with the received physical therapy (PT) is a necessary part of PT system analysis. The purpose of the study was to investigate the effect of incentive spirometry on pulmonary function recovery and the level of satisfaction with PT in patients undergoing cardiac surgery.Materials and methods: 70 patients of both sexes were randomly divided into сontrol group (CG) and training group (TG). Both groups received standardized PT (early mobilization, therapeutic exercises, coughing). TG patients also used Tri-Ball breathing exerciser (flow-oriented incentive spirometry). Outcome Measures: the indicators of pulmonary function and satisfaction with PT results on the 7th postoperative day.Results: Pulmonary function results were statistically the same in CG and TG both before the surgery and on the seventh postoperative day. According to the results of the assessment of patient satisfaction with PT, none of the groups showed advantages in any of the seventeen items. Both groups of patients showed high scores in all items of PT satisfaction questionnaire. The overall score had no statistical difference in the groups as well: 82.5 (79; 85) points in CG and 80.5 (74.75; 85) points in TG (p = 0.315) out of a maximum of 85 points.Conclusions: The investigation of pulmonary function and patient satisfaction with the received physical therapy did not confirm the effect of flow-oriented incentive spirometry included in the physical therapy program on the level of satisfaction and pulmonary function test results.
Резюме. Мета: оцінити вплив вправ з глибоким диханням на рівень тривоги та депресії серед кардіохірургічних пацієнтів. Матеріали і методи. У дослідженні взяли участь 75 пацієнтів, котрим виконувалось кардіохірургічне втручання. Пацієнтів було випадковим чином розділено (у співвідношенні 1:1, метод конвертів) на контрольну групу (КГ, n=38) та тренувальну групу (ТГ, n=37). Перед операцією пацієнти отримували коротку консультацію фізичного терапевта щодо цілей та змісту фізичної терапії, алгоритму активізації після операції. Післяопераційний протокол передбачав ранню мобілізацію пацієнта та заняття з фізичним терапевтом. За необхідності (стан пацієнта, необхідність мотивації) кількість та/чи тривалість занять могла збільшуватися за рішенням фізичного терапевта. Для пацієнтів КГ респіраторна фізична терапія обмежувалася кашлем. Пацієнти ТГ додатково виконували дихальні вправи з глибоким диханням. Для оцінки рівня тривоги та депресії застосовувалася Госпітальна шкала тривоги та депресії. Результати дослідження. Відмінностей у антропометричних показниках, функціональному класі NYHA, часових показниках операції не встановлено. Відповідно до результатів першого анкетування, рівні тривоги та депресії не відрізнялися у КГ і ТГ: ±S для тривоги становили відповідно 7,68±3,89 бала і 6,48±3,25 бала (р=0,153), а для депресії 5,66±4,11 і 5,89±3,31 (р=0,787). Аналогічний висновок отримано й при порівнянні результатів груп заключного анкетування: тривога ‑ 4(1; 7,25) бала проти 5(3; 8) балів (р=0,263); депресія ‑ 4,74±3,25 бала проти 5,54±3,61 бала (р=0,314). Висновки. Позитивного ефекту від включення вправ з глибоким диханням до післяопераційної програми фізичної терапії на динаміку показників тривоги та депресії не встановлено.
Objective: To investigate the effect of using Tri-Ball breathing exerciser on the results of the pulmonary function test in the patients undergoing cardiac surgery. Design: prospective randomized controlled trial. Setting: hospitalized care. Participants: 66 patients of both sexes were randomly divided into control group (CG) and training group (TG). Interventions: Both groups received standardized physical therapy (early mobilization; therapeutic exercises; chest wall vibrations; percussions; coughing; calm deep breathing without simultaneous movements of the limbs or other parts of the body to rest between therapeutic exercises and reduce respiratory and heart rates). TG patients also used Tri-Ball breathing exerciser to train inspiratory muscles. Main Outcome Measures: the results of the pulmonary function test before the surgery and on the 7 postoperative day. Results: pulmonary function had no statistical difference in CG and TG patients both before the surgery and on the 7 postoperative day. Vital capacity reduced from 103.81 ± 13.20% to 76.84 ± 14.65% in CG and from 104.18 ± 13.20% to 76.38 ± 16.18% in TG. The reduction of peak expiratory flow was less pronounced in both groups: from 96.91 ± 14.05% to 79.19 ± 18.08% in CG and from 98.77 ± 19.38% to 82.03 ± 20.75% in TG. Inspiratory indicators (forced inspiratory vital capacity, forced inspiratory volume in one second, peak inspiratory flow) also did not confirm any additional benefit of using Tri-Ball breathing exercises, despite the fact that it is aimed to train deep, strong and quick inhalation. Tiffeneau index had no statistical changes in CG (p = .257), though it showed statistical improvement in TG (p = .031). Conclusions: The study did not confirm any benefits of using Tri-Ball breathing exercises in the physical therapy program.
The purpose of the study was to determine and compare the indicators of the therapeutic alliance based on the results of a survey of cardiac surgery patients and their physical therapists. Material and methods. The survey involved 100 patients (over 18 years old, without cognitive impairment) who underwent cardiac surgery. The Working Alliance Inventory questionnaire was used to assess the level of therapeutic alliance formation. The SF Hatcher Client form (which consists of 12 questions) was used for the patient. These questions were divided into three groups / domains: "goal items", "task items" and "bond items". The questionnaire was filled in on the seventh postoperative day. The SF Hatcher Client form, which consisted of 12 questions, was used for the patient. Intervention: before surgery, patients received a short consultation with a physical therapist regarding the goals and content of physical therapy, the algorithm for activation after surgery; the postoperative physical therapy protocol included early mobilization, therapeutic gymnastics, the use of respiratory physical therapy techniques, and therapeutic walking under the supervision of a physical therapist. Patients were provided with information and tasks on therapeutic walking, a small set of therapeutic exercises and breathing physical therapy for independent implementation. Results and discussion. The indicators of the therapeutic alliance between physical therapists and cardiac surgery patients confirmed its high level, both according to the results of the questionnaire survey of patients and the results of the survey of specialists. The "goal items" domain had the highest score in the patient's assessment of therapeutic alliance. Since the patient and specialist questionnaires had a different number of questions and a different maximum score, it was decided to make comparisons of the overall estimates of the level of therapeutic alliance after converting them to a percentage of the maximum. A significantly better overall score for the therapeutic alliance was established according to the results of the questionnaire survey of physical therapists: 87.5 (82.5; 95) % of the maximum versus 81.25 (66.67; 89.58) % of the maximum (p = 0.000). Conclusion. Physical therapists rated the therapeutic alliance for a higher score
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