eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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2/2019
vol. 16
 
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abstract:
Original paper

The effect of preoperative respiratory physiotherapy and motor exercise in patients undergoing elective cardiac surgery: short-term results

Paolo Nardi
1
,
Antonio Pellegrino
1
,
Calogera Pisano
1
,
Sara Rita Vacirca
1
,
Deborah Anselmi
2
,
Silvia Saulle
3
,
Romana Dandi
3
,
Alessia Romano
3
,
Annamaria Servadio
4
,
Alessandra Gianlorenzi
5
,
Giovanni Ruvolo
1

  1. Cardiac Surgery Division, Tor Vergata University Hospital, Rome, Italy
  2. Degree of Physiotherapy, Tor Vergata University Hospital, Rome, Italy
  3. Physiotherapy Service, Tor Vergata University Hospital, Rome, Italy
  4. Management Coordinator Rehabilitation Area, Tor Vergata University Hospital, Rome, Italy
  5. Management Coordinator Cardiac Surgery Unit, Tor Vergata University Hospital, Rome, Italy
Kardiochirurgia i Torakochirurgia Polska 2019; 16 (2): 81-87
DOI: https://doi.org/10.5114/kitp.2019.86360
Online publish date: 2019/06/28
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Introduction
Loss of physical activity and pulmonary dysfunction with its associated complications represent two of the most important causes of morbidity and mortality following cardiac surgery. Few studies have investigated the effects of preoperative interventions targeted at improving cardiorespiratory and musculoskeletal function in the postoperative period.

Aim
To evaluate whether a physiotherapy program based on respiratory training with or without musculoskeletal mobilization, started preoperatively, may provide a significant improvement in pulmonary and musculoskeletal recovery postoperatively in patients undergoing elective cardiac surgery.

Material and methods
Patients with similar baseline and preoperative characteristics were randomly assigned to a preoperative respiratory physiotherapy protocol (group A), a preoperative respiratory and motor physiotherapy protocol (group B), or no preoperative specific physiotherapy protocol but only a simplified perioperative standard physiotherapy protocol (control group or group C). Group A consisted of 19 patients, group B of 20, group C of 20. Data on 6-minute walking test, peak expiratory flow, and from blood gas analysis were retrospectively analyzed.

Results
As compared with group C, a statistically significant improvement was observed in the two preoperatively treated groups A and B in terms of longer pre- and postoperative distance traveled at the 6-minute walking test, better pre- and postoperative peak expiratory flow value, and better PaO2 and SaO2 values in postoperative blood gas measurements (p < 0.05, for all comparisons). A statistically significant reduction of the postoperative length of in-hospital stay was also observed in group B.

Conclusions
As compared with the control group, substantially better clinical results for respiratory and musculoskeletal function were found in the groups preoperatively treated with physiotherapeutic protocols immediately before as well as after cardiac surgery.

keywords:

physiotherapy, motor exercise, cardiac surgery
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