Análise das respostas hemodinâmicas e respiratórias durante protocolo de exercícios com cicloergômetro x fisioterapia motora convencional em pós-operatório de cirurgia cardíaca

Abstract

Introduction: Cardiovascular disease is the leading cause of mortality wordwide, and cardiac surgery hás been increasing the chance of survival and improving the quality of life of the population with these diseases. The role of physical therapy in cardiac rehabilitation is to help this patient return to society with a functional improvement. In addition to the benefits of conventional exercise already demonstrated in the literature, the cycle ergometer has proven to be a safe therapy option in this patient population. Objective: To compare how hemodynamic and respiratory changes in postoperative cardiac surgery patients, using training with a lower limb load cycle ergometer and conventional physiotherapy. Method: A randomized crossover interventional study including 19 subjects on the second postoperative day of cardiac surgery: all patients included in this study underwent two protocols: twenty minutes of exercise with lower limb cycle ergometer (CE) and twenty minutes of active lower limb exercise (EA). The order of application of the protocol was defined by lot through identical and sealed envelopes, per person not involved in the study. The researcher responsible for the protocol knew the order of intervention at the time of data collection. Results: When comparing the CE X EA groups, the sensation of dyspnea was higher in the EA group, 5 min EA: (2.36) (2.03) CE: (1.68) (1.88) p = 0.032; 10 min EA: (3.00) (1.97) CE: (2.36) (2.27) p = 0.045; 15 min EA: (2.36) (2.54) CE: (2.57) (2.39) p = 0.045) and SBP was higher at the fifth minute in the CE group, 5 min EA: (112.42) (25.70) CE: (121.31) (15.71) (p = 0.005). In the intragroup comparison the sensation of dyspnea increased during the two protocols CE (85.63) (1.35) p = 0.000 and EA (85.13) (1.23) p = 0.000, the RF increased up to the fifth minute in both CE (22.89) (1.28) p = 0.000 and EA (22.87) (14.71) p = 0.000 groups and HR increased to the tenth minute in both CE protocols (89.90) (1.49) p = 0.000 and EA (89.87) (1.57) p = 0.000.Conclusion: Both protocols are safe for the promotion of cardiovascular conditioning with little hemodynamic and respiratory repercussion in this patient population.