Course of Physiotherapy, University of Itauna, Itauna, Brazil.
Obes Surg. 2011 Sep;21(9):1389-94. doi: 10.1007/s11695-010-0349-y.
This study seeks to assess the effect of inspiratory muscle training (IMT) on pulmonary function, respiratory muscle strength, and endurance in morbidly obese patients submitted to bariatric surgery.
Thirty patients were randomly assigned to sham muscular training, or to IMT with a threshold device (40% of maximum inspiratory pressure, MIP), for 30 min/day, from the 2nd until 30th postoperative (PO) day. All of them were submitted to a standard respiratory kinesiotherapy and early deambulation protocol. Data on spirometry, maximum static respiratory pressures, and respiratory muscle endurance were collected on the PO days 2, 7, 14, and 30 in a blinded matter.
IMT enabled increases in PO MIP and endurance, and an earlier recovery of the spirometry parameters FEV(1), PEF, and FEF(25-75%). Comparing to preoperative values, MIP was increased by 13% at the 30th PO day in the trained group, whereas control group had a reduction of 8%, with higher values for the IMT group (30th PO, IMT-130.6 ± 22.9 cmH(2)O; controls-112.9 ± 25.1 cmH(2)O; p < 0.05). Muscular endurance at the 30th PO day was increased in the trained group comparing to preoperative value (61.5 ± 39.6 s vs 114.9 ± 55.2 s; p < 0.05), a finding not observed in the control group (81.7 ± 44.3 vs 95.2 ± 42.0 s).
IMT improves inspiratory muscle strength and endurance and accounts for an earlier recovery of pulmonary airflows in morbidly obese patients submitted to bariatric surgery.
本研究旨在评估吸气肌训练(IMT)对病态肥胖患者接受减重手术后肺功能、呼吸肌力量和耐力的影响。
30 名患者被随机分配到假肌肉训练组或使用阈值设备(最大吸气压力的 40%,MIP)的 IMT 组,每天进行 30 分钟的训练,从术后第 2 天到第 30 天。所有患者均接受标准呼吸运动疗法和早期离床活动方案。在盲法状态下,于术后第 2、7、14 和 30 天收集肺活量、最大静态呼吸压力和呼吸肌耐力的数据。
IMT 使术后第 30 天的 MIP 和耐力增加,并使肺活量参数 FEV(1)、PEF 和 FEF(25-75%)更早恢复。与术前值相比,训练组在术后第 30 天的 MIP 增加了 13%,而对照组则减少了 8%,训练组的 MIP 值更高(第 30 天 PO,IMT-130.6±22.9 cmH(2)O;对照组-112.9±25.1 cmH(2)O;p<0.05)。与术前值相比,训练组在术后第 30 天的肌肉耐力增加(61.5±39.6 s 与 114.9±55.2 s;p<0.05),而对照组则没有观察到这种变化(81.7±44.3 与 95.2±42.0 s)。
IMT 可改善病态肥胖患者接受减重手术后的吸气肌力量和耐力,并促进肺通气的更早恢复。