Comparação de força muscular periférica após diferentes protocolos de reabilitação fase 1 em pacientes submetidos à cirurgia cardíaca

Abstract

Introduction: Physiotherapeutic intervention in the immediate postoperative period of cardiac surgery is fundamental, the rehabilitation program in this phase must address early mobilization. Evaluating peripheral muscle strength through dynamometry and the MRC scale at patient admission and discharge is an objective, less expensive and non-invasive way to monitor possible functional declines during hospitalization and, above all, the effectiveness of the proposed interventions. Objective: To evaluate the impacts of different rehabilitation protocols (conventional physiotherapy x cycle ergometer) on peripheral muscle strength in patients undergoing cardiac surgery. Methodology: From August to November 2022, 24 individuals undergoing cardiac surgery with median sternotomy were included and distributed in the intervention groups: cycle ergometer protocol (PCE) or conventional physical therapy protocol (PFC), in both groups the subjects underwent to 3 daily sessions of exercises for 20 minutes in the morning, afternoon and evening. Peripheral muscle strength was assessed preoperatively and at discharge from the Coronary Intensive Care Unit (ICU-COR) using dynamometry and the MRC scale (Medical Research Council). Results: There was a predominance of male patients in both groups. When comparing the values of measurements before and at the time of discharge from the COR-ICU in the PFC group of Dynamometry (34.94±8.39 x 33.06±6.89) (p<0.3) and MRC ( 59, 3±0.48 x 58.5 ±1.36) (p<0.1) there was no statistically significant difference. The same occurred in the PCE Dynamometry group (30.63±9.68 x 28.93±8.71) (p<0.3) and MRC (57.4 ± 3.71 x 55.6 ± 4.84) (p<0.5). In the inter-group comparison PFC x PCE for Dynamometry (p<0.9) and MRC (p<0.7) values, there were no differences. Conclusion: This study demonstrated that patients submitted to different rehabilitation protocols in the postoperative period of cardiac surgery maintained peripheral muscle strength during the period of stay in the COR-ICU and that there was no significant difference between them.