Breathing Pattern Dysfunction and Physical Activity of Patients Following a Median Sternotomy After Hospital Discharge: A Cross-Sectional Study.

BACKGROUND AND AIMS

Patients following cardiac surgery experience alterations in pulmonary function and respiratory muscle strength during hospital stay. Inefficient breathing affects functional movement and influences health and wellness. The purpose was to determine the physical activity and breathing pattern dysfunction in patients following a median sternotomy after the hospital and identify the factors contributing to the dysfunction.

METHODS

A cross-sectional study, using telehealth video consultations, took place from December 2022 to November 2023, 3 months to 1 year after hospital discharge. The presence of breathing pattern dysfunction was determined using the Nijmegen Questionnaire, the Self-Evaluation of Breathing Questionnaire, the Breath Hold Time test, and chest expansion evaluation. The Physical Activity Vital Sign provides information on physical activity. Descriptive and inferential statistical analysis was done with statistical significance set at  ≤ 0.05.

RESULTS

The population consisted of 52 adults (median age, 57 (14 IQR) years;  = 31 (59. 6%) males). Most underwent surgery for coronary artery bypass grafting ( = 27 [51.9%]) and spent 7 (IQR 8) days in hospital. In total, 46 (88.5%) participated in weekly aerobic exercise of a median duration of 140 (IQR 228) minutes. Only 11 (21.15%) reported strength training. Rating of breathing pattern dysfunction was Nijmegen Questionnaire 16.98 (±9.76) versus Self-Evaluation of Breathing Questionnaire 10.00 (IQR 12), and  = 20 (38.5%) and  = 8 (15.4%) scored positive for breathing pattern dysfunction, respectively. The mean Breath Hold Time test was 21.60 (±5.94) seconds. Increasing weekly aerobic exercise was associated with the Self-Evaluation of Breathing Questionnaire ( = -0.30,  = 0.03), Breath Hold Time test ( = 0.29,  = 0.04), lower chest expansion ( = 0.39,  = 0.003), and upper chest expansion ( = 0.33,  = 0.02).

CONCLUSION

Breathing pattern dysfunction is present long-term and weekly participation in aerobic exercise lessens this dysfunction. Health education and advocacy for participation in cardiac rehabilitation are required to enhance physical activity levels and reduce inefficient breathing.