Evangelodimou Aphrodite, Patsaki Irini, Andrikopoulos Alexandros, Chatzivasiloglou Foteini, Dimopoulos Stavros
Laboratory of Advanced Physiotherapy, Physiotherapy Department, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece.
Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, 1st Critical Care Department, Evangelismos Hospital, School of Medicine, National and Kapodistrian University of Athens, 10675 Athens, Greece.
J Cardiovasc Dev Dis. 2024 Nov 27;11(12):380. doi: 10.3390/jcdd11120380.
Cardiac surgery procedures are among the main treatments for people with cardiovascular disease, with physiotherapy playing a vital part. Respiratory complications are common and associated with prolonged Intensive Care Unit (ICU) and hospital stay, as well as increased mortality. Inspiratory muscle training has been found to be beneficial in improving respiratory muscle function in critically ill patients and patients with heart failure. The purpose of this review is to present the results of implementing inspiratory muscle training (IMT) programs in patients before and/or after cardiac surgery. The PubMed, Embase and Science Direct databases were searched from January 2012 to August 2023. In the present review, randomized controlled clinical trials (RCTs), clinical trials and quasi-experimental studies conducted in adult patients pre and/or post cardiac surgery were included. Fifteen studies were considered eligible for inclusion in the review. The results revealed that the IMT programs varied in intensity, repetitions, and duration in all included studies. Most studies implemented the IMT after the surgery. Statistical significance between groups was noted in Maximal Inspiratory Pressure and the 6-Minute Walk Distance Test. Preoperative and postoperative programs could improve inspiratory muscle strength, pulmonary function, and functional capacity as well as decrease the length of hospital stay in patients undergoing cardiac surgery. No clear evidence emerged favoring low or higher IMT intensities. The combination of IMT with other forms of exercise might be beneficial in patients undergoing cardiac surgery. However, further RCTs are required to provide confirming evidence.
心脏外科手术是心血管疾病患者的主要治疗手段之一，物理治疗在其中起着至关重要的作用。呼吸并发症很常见，与重症监护病房（ICU）住院时间延长、住院时间延长以及死亡率增加有关。吸气肌训练已被发现有助于改善重症患者和心力衰竭患者的呼吸肌功能。本综述的目的是介绍在心脏手术前和/或后对患者实施吸气肌训练（IMT）计划的结果。检索了2012年1月至2023年8月期间的PubMed、Embase和Science Direct数据库。在本综述中，纳入了在成年心脏手术患者术前和/或术后进行的随机对照临床试验（RCT）、临床试验和准实验研究。15项研究被认为符合纳入综述的条件。结果显示，在所有纳入的研究中，IMT计划在强度、重复次数和持续时间方面各不相同。大多数研究在手术后实施IMT。在最大吸气压力和6分钟步行距离测试中，两组之间存在统计学意义。术前和术后计划可以提高吸气肌力量、肺功能和功能能力，并缩短心脏手术患者的住院时间。没有明确的证据表明低强度或高强度的IMT更有利。IMT与其他形式的运动相结合可能对心脏手术患者有益。然而，需要进一步的RCT来提供确凿的证据。
