Impactos de diferentes programas de reabilitação sobre a força muscular respiratória em pacientes submetidos a cirurgia cardíaca

Abstract

Introduction: Cardiac surgery is an invasive and complex procedure, which can lead to several complications including respiratory and motor disorders. After cardiac surgery, there is a decrease in respiratory and peripheral muscle strength, increasing the morbidity and mortality of these patients. Objective: To compare the effects of different rehabilitation protocols (Conventional Physiotherapy X Cycle ergometer) on respiratory muscle strength in patients undergoing cardiac surgery. Methods: From August to November 2022, 24 individuals who underwent cardiac surgery with median sternotomy were included and distributed into the intervention groups: cycle ergometer (GC) or conventional physical therapy (GFC). In both groups, the subjects were submitted to 3 daily sessions of exercises for 20 minutes in the morning, afternoon and night. Respiratory muscle strength was assessed preoperatively and at discharge from the Coronary Intensive Care Unit (ICU-COR) using manovacuometry. Results: The results were divided between the different interventions. Cycle ergometer Group (GC), eleven subjects and Conventional Physical Therapy Group (GFC) thirteen of these, 17 men (70,83%) and 7 women (29,16%). A significant reduction in respiratory muscle strength was observed at discharge from the COR-ICU compared to the preoperative period in both groups, both for Pimax GFC values (67.7 ± 16.51 x 44.2 ± 11.2, p= 0.02) GC (60.1 ± 19.9 vs. 43.2 ± 1 2.52, p=0.009) how much of Pemax GFC (94.9 ± 21.29 X 70.7 ± 28.12, p=0.007) GC (88.7 ± 32.08 x 62.4 ± 19.77, p=0.02). In the intergroup comparison of pre- and discharge values from the COR-ITU, there was no difference. Conclusion: When evaluating the impact of different rehabilitation programs on respiratory muscle strength in patients undergoing cardiac surgery, there was a decrease in respiratory muscle strength at the time of discharge from the COR-ICU when compared to the preoperative period. It was also seen that there was no difference between treatments related to respiratory muscle strength.