Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 10 , Pages 1685-1691 , October 2009

Inspiratory Muscle Strength as a Determinant of Functional Capacity Early After Coronary Artery Bypass Graft Surgery

  • Ricardo Stein, MD, ScD

      Affiliations

    • Exercise Pathophysiology Research Laboratory, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
    • Cardiology Division, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
    • Veterans Affairs Palo Alto Health Care System, Stanford University, Palo Alto, CA
    • Corresponding Author InformationReprint requests to Ricardo Stein, MD, ScD, Laboratório de Fisiopatologia do Exercício Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Sala 2061, CEP: 90035-903, Porto Alegre, RS, Brazil
    • ,
  • Cristiano P. Maia, PT, MSc

      Affiliations

    • Exercise Pathophysiology Research Laboratory, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
    • ,
  • Anderson D. Silveira, MD

      Affiliations

    • Exercise Pathophysiology Research Laboratory, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
    • ,
  • Gaspar R. Chiappa, PT, ScD

      Affiliations

    • Exercise Pathophysiology Research Laboratory, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
    • Exercise Biochemistry and Physiology Laboratory, Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Criciúma, Brazil
    • ,
  • Jonathan Myers, PhD

      Affiliations

    • Veterans Affairs Palo Alto Health Care System, Stanford University, Palo Alto, CA
    • ,
  • Jorge P. Ribeiro, MD, ScD

      Affiliations

    • Exercise Pathophysiology Research Laboratory, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
    • Cardiology Division, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
    • Department of Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil

References 

  1. Johnson D, Kelm C, Hurst T, Burdridge B, Mayers I. Postoperative physical therapy after coronary artery bypass surgery. Am J Respir Crit Care Med. 1995;152:953–958
  2. Hulzebos EH, Helders PJ, Favié NJ, De Bie RA, Brutel de la Riviere A, Van Meeteren NL. Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high-risk patients undergoing CABG: a randomized clinical trial. JAMA. 2006;296:1851–1857
  3. Pasquina P, Tramer MR, Walder B. Prophylactic respiratory physiotherapy after cardiac surgery: systematic review. BMJ. 2003;327:1379–1381
  4. Haeffener MP, Ferreira MG, Menna-Barreto SS, Arena R, Dall'Ago P. Incentive spirometry with expiratory positive airway pressure reduces pulmonary complications, improves pulmonary function and 6-minute walk distance in patients undergoing coronary artery bypass graft surgery. Am Heart J. 2008;156:900.e1–900.e8
  5. Hirschhorn AD, Richards D, Mungovan SF, Morris NR, Adams L. Moderate intensity exercise improves distance walked at hospital discharge following coronary artery bypass graft surgery—a randomised controlled trial. Heart Lung Circ. 2008;17:129–138
  6. ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1999 Guidelines for Coronary Artery Bypass Graft Surgery). Circulation. 2004;110:e340–e437
  7. American Thoracic Society. Standardization of Spirometry, 1994 update. Am J Respir Crit Care Med. 1995;152:1107–1136
  8. Knudson RJ, Slatin RC, Lebowitz MD. The maximal expiratory flow-volume curve: normal standards, variability and effects of age. Am Rev Respir Dis. 1976;113:587–600
  9. Dall'Ago P, Chiappa GR, Guths H, Stein R, Ribeiro JP. Inspiratory muscle training in patients with heart failure and inspiratory muscle weakness. J Am Coll Cardiol. 2006;47:757–763
  10. Neder JA, Andreoni S, Lerario MD, Nery LE. Reference values for lung function tests, II: maximal respiratory pressures and voluntary ventilation. Braz J Med Biol Res. 1999;32:719–727
  11. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166:111–117
  12. Novitsky S, Segal KR, Chatr-Aryamontri B, et al. Validity of a new portable indirect calorimeter: the AeroSport TEEM 100. Eur J Appl Physiol Occup Physiol. 1995;70:462–467
  13. Crowe JM, Bradley CA. The effectiveness of incentive spirometry with physical therapy for high-risk patients after coronary artery bypass surgery. Phys Ther. 1997;77:260–268
  14. Borghi-Silva A, Mendes RG, Costa de FM, Lorenzo VA, Oliveira CR, Luzzi S. The influences of positive end expiratory pressure (PEEP) associated with physiotherapy intervention in phase I cardiac rehabilitation. Clinics. 2005;60:465–472
  15. Dull J, Dull W. Are maximal inspiratory breathing exercises or incentive spirometry better than early mobilization after cardiopulmonary bypass?. Phys Ther. 1983;63:655–659
  16. Westerdahl E, Lindmark B, Erikson T, Friberg O, Hedenstierna G, Tenling A. Deep-breathing exercises reduce atelectasis and improve pulmonary function after coronary artery bypass surgery. Chest. 2005;128:3482–3488
  17. Vibarel N, Hayot M, Ledermann B, Messner P, Ramonatxo M, Prefaut C. Effect of aerobic exercise training on inspiratory muscle performance and dyspnoea in patients with chronic heart failure. Eur J Heart Fail. 2002;4:745–751
  18. Arthur HM, Daniels C, McKelvie R, Hirsh J, Rush B. Effect of a preoperative intervention on preoperative and postoperative outcomes in low-risk patients awaiting elective coronary artery bypass graft surgery. Ann Intern Med. 2000;133:253–262
  19. Herdy AH, Marcchi PL, Vila A, et al. Pre- and postoperative cardiopulmonary rehabilitation reduces complications after coronary artery bypass surgery: a randomized trial. Am J Phys Med Rehabil. 2008;87:714–719
  20. Opasich C, Feo SD, Pina GD, et al. Distance walked in 6-minute walk test soon after cardiac surgery. Chest. 2004;126:1791–1801

 Supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior and Conselho Nacional de Desenvolvimento Científico Tecnológico, Brasília, Brazil, and Fundo de Incentivo a Pesquisa e Eventos—Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.

 ClinicalTrials.gov Identifier: NCT00873028.

PII: S0003-9993(09)00409-2

doi: 10.1016/j.apmr.2009.05.010

Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 10 , Pages 1685-1691 , October 2009

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