Postoperative inspiratory muscle training in addition to breathing exercises and early mobilization improves oxygenation in high-risk patients after lung cancer surgery: a randomized controlled trial

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Postoperative inspiratory muscle training in addition to breathing exercises and early mobilization improves oxygenation in high-risk patients after lung cancer surgery : a randomized controlled trial

Brocki, Barbara Cristina, 1957- (författare): Örebro universitet,Institutionen för hälsovetenskap och medicin,Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark

Andreasen, Jan Jesper (författare): Aalborg University, Aalborg, Denmark

Langer, Daniel (författare): Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium

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Souza, Domingos S. R. (författare): Faculty of Medicine and Health, Surgery, Örebro University, Örebro, Sweden

Westerdahl, Elisabeth, 1964- (författare): Örebro universitet,Institutionen för hälsovetenskap och medicin

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2015-10-20
2016
Engelska.
Ingår i: European Journal of Cardio-Thoracic Surgery. - : Oxford University Press. - 1010-7940 .- 1873-734X. ; 49:5, s. 1483-1491

Relaterad länk:: https://doi.org/10.1...; visa fler...; https://academic.oup...; https://urn.kb.se/re...; https://doi.org/10.1...; visa färre...

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Abstract Ämnesord

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OBJECTIVES The aim was to investigate whether 2 weeks of inspiratory muscle training (IMT) could preserve respiratory muscle strength in high-risk patients referred for pulmonary resection on the suspicion of or confirmed lung cancer. Secondarily, we investigated the effect of the intervention on the incidence of postoperative pulmonary complications.METHODS The study was a single-centre, parallel-group, randomized trial with assessor blinding and intention-to-treat analysis. The intervention group (IG, n = 34) underwent 2 weeks of postoperative IMT twice daily with 2 × 30 breaths on a target intensity of 30% of maximal inspiratory pressure, in addition to standard postoperative physiotherapy. Standard physiotherapy in the control group (CG, n = 34) consisted of breathing exercises, coughing techniques and early mobilization. We measured respiratory muscle strength (maximal inspiratory/expiratory pressure, MIP/MEP), functional performance (6-min walk test), spirometry and peripheral oxygen saturation (SpO2), assessed the day before surgery and again 3–5 days and 2 weeks postoperatively. Postoperative pulmonary complications were evaluated 2 weeks after surgery.RESULTS The mean age was 70 ± 8 years and 57.5% were males. Thoracotomy was performed in 48.5% (n = 33) of cases. No effect of the intervention was found regarding MIP, MEP, lung volumes or functional performance at any time point. The overall incidence of pneumonia was 13% (n = 9), with no significant difference between groups [IG 6% (n = 2), CG 21% (n = 7), P = 0.14]. An improved SpO2 was found in the IG on the third and fourth postoperative days (Day 3: IG 93.8 ± 3.4 vs CG 91.9 ± 4.1%, P = 0.058; Day 4: IG 93.5 ± 3.5 vs CG 91 ± 3.9%, P = 0.02). We found no association between surgical procedure (thoracotomy versus thoracoscopy) and respiratory muscle strength, which was recovered in both groups 2 weeks after surgery.CONCLUSIONS Two weeks of additional postoperative IMT, compared with standard physiotherapy alone, did not preserve respiratory muscle strength but improved oxygenation in high-risk patients after lung cancer surgery. Respiratory muscle strength recovered in both groups 2 weeks after surgery.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Sjukgymnastik (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Physiotherapy (hsv//eng)

Nyckelord

Inspiratory muscle training
lung cancer
surgery
pulmonary complications
postoperative
physiotherapy
Kirurgi, särskilt thoraxkirurgi
Surgery esp. Thoracic and Cardivascular Surgery

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Av författaren/redakt...: Brocki, Barbara ...; Andreasen, Jan J ...; Langer, Daniel; Souza, Domingos ...; Westerdahl, Elis ...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kirurgi

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Hälsovetenskap; och Sjukgymnastik

Artiklar i publikationen: European Journal ...

Av lärosätet: Örebro universitet

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