School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey.
Department of Chest Surgery, Kent Hospital, İzmir, Turkey.
Physiother Theory Pract. 2020 Mar;36(3):378-385. doi: 10.1080/09593985.2018.1488189. Epub 2018 Jul 6.
: The effects of preoperative respiratory muscle training (RMT) on postoperative complications in patients with pulmonary resection have recently attracted the attention of researchers. More studies are obviously needed to clarify the effects of RMT after pulmonary resection. The aim of this study was to evaluate the effectiveness of intense RMT in addition to chest physiotherapy after pulmonary resection in terms of respiratory muscle strength, exercise capacity, and length of hospital stay rather than postoperative complications. : Forty subjects undergoing pulmonary resection were included in the study. Subjects were divided into two groups using a simple randomization method. The subjects in the study group (SG; = 20) received RMT in addition to regular chest physiotherapy in the postoperative period. The subjects in the control group (CG; = 20) received only regular chest physiotherapy. Respiratory muscle strength (maximal inspiratory and expiratory pressure [PI and PE]) was measured pre-postoperatively and before discharge, and exercise capacity, which was measured by the 6-min walk test (6MWT), was assessed preoperatively and before discharge. The length of hospital stay was also recorded. : There were no differences between groups in terms of demographic and surgical characteristics. The nonsignificant change of PI from the preoperative to the discharge value was 65.1 ± 15.5 to 68.2 ± 19.2 cmHO in SG and 59.2 ± 13.7 to 44.3 ± 14.8 cmHO in CG ( > 0.05, > 0.05, respectively). The change of PE from the preoperative to the discharge value was 80.4 ± 24.9 to 81.5 ± 24.9 cmHO in SG (nonsignificant) and 85.4 ± 38.2 to 61.3 ± 25.4 cmHO in CG ( > 0.05, = 0.002, respectively). There was a significant difference between SG and CG in terms of RMT effect (PI: 11.05 [21.84; 0.25] cmHO = 0.045; PE: 25.23 [42.83; 7.62] cmHO = 0.006). A significant difference was found in the 6MWT when the mean differences were compared between the groups (85.72 [166.15; 5.28] m = 0.037). The length of hospital stay was significantly shorter in the SG (number of days for SG 9.1 ± 3 and for CG 12.9 ± 4.2 [= 0.002]). : The addition of RMT to chest physiotherapy after pulmonary resection can have positive effects on respiratory muscle strength, exercise capacity, and length of hospital stay.
术前呼吸肌训练(RMT)对肺切除术后患者术后并发症的影响最近引起了研究人员的关注。显然需要更多的研究来阐明肺切除术后 RMT 的效果。本研究旨在评估肺切除术后除常规胸部物理治疗外,强化 RMT 对呼吸肌力量、运动能力和住院时间(而不是术后并发症)的影响。
研究纳入了 40 名接受肺切除术的患者。采用简单随机分组方法将患者分为两组。研究组(SG;=20)在术后除常规胸部物理治疗外还接受 RMT。对照组(CG;=20)仅接受常规胸部物理治疗。术前和出院前测量呼吸肌力量(最大吸气和呼气压力[PI 和 PE]),术前和出院前评估运动能力(6 分钟步行试验[6MWT]),并记录住院时间。
两组在人口统计学和手术特征方面无差异。SG 组 PI 从术前到出院时的无显著变化值为 65.1±15.5 至 68.2±19.2 cmH2O,CG 组为 59.2±13.7 至 44.3±14.8 cmH2O(均>0.05,均>0.05)。PE 从术前到出院时的变化值在 SG 组为 80.4±24.9 至 81.5±24.9 cmH2O(无显著差异),在 CG 组为 85.4±38.2 至 61.3±25.4 cmH2O(均>0.05,=0.002)。SG 和 CG 组在 RMT 效果方面存在显著差异(PI:11.05[21.84;0.25]cmH2O=0.045;PE:25.23[42.83;7.62]cmH2O=0.006)。当比较组间平均差异时,6MWT 存在显著差异(85.72[166.15;5.28]m=0.037)。SG 组的住院时间明显短于 CG 组(SG 组 9.1±3 天,CG 组 12.9±4.2 天[=0.002])。
肺切除术后在常规胸部物理治疗的基础上附加 RMT 可以对呼吸肌力量、运动能力和住院时间产生积极影响。