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Feasibility of preoperative inspiratory muscle training in patients undergoing coronary artery bypass surgery with a high risk of postoperative pulmonary complications: a randomized controlled pilot study

Section Rehabilitation, Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, The Netherlands, h.hulzebos{at}umcutrecht.nl

Nico LU van Meeteren

Section Rehabilitation, Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht and Department of Physiotherapy-Research, Academy of Health Sciences Utrecht, The Netherlands

Bram JWM van den Buijs

Section Rehabilitation, Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, The Netherlands

Rob A de Bie

Physiotherapy-Research, Department of Epidemiology, Maastricht University, Maastricht, The Netherlands

A Brutel de la Rivière

Department of Thorax Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands

Paul JM Helders

Department of Paediatric Physical Therapy, University Medical Centre and Children’s Hospital Utrecht and Department of Physiotherapy-Research, Academy of Health Sciences Utrecht, The Netherlands

Objective: To determine in a pilot study the feasibility and effects of preoperative inspiratory muscle training in patients at high risk of postoperative pulmonary complications who were scheduled for coronary artery bypass graft surgery.

Design: Single-blind, randomized controlled pilot study.

Setting: University Medical Centre Utrecht, the Netherlands.

Subjects: Twenty-six patients at high risk of postoperative pulmonary complications were selected.

Intervention: The intervention group (N = 14) received 2-4 weeks of preoperative inspiratory muscle training on top of the usual care received by the patients in the control group.

Main measures: Primary outcome variables of feasibility were the occurrence of adverse events, and patient satisfaction and motivation. Secondary outcome variables were postoperative pulmonary complications and length of hospital stay.

Results: The feasibility of inspiratory muscle training was good and no adverse events were observed. Treatment satisfaction and motivation, scored on 10-point scales, were 7.9 (± 0.7) and 8.2 (± 1.0), respectively. Postoperative atelectasis occurred in significantly fewer patients in the intervention group than in the control group (²_DF1 = 3.85; P = 0.05): Length of hospital stay was 7.93 (± 1.94) days in the intervention group and 9.92 (± 5.78) days in the control group (P = 0.24).

Conclusion: Inspiratory muscle training for 2-4 weeks before coronary artery bypass graft surgery was well tolerated by patients at risk of postoperative pulmonary complications and prevented the occurrence of atelectasis in these patients. A larger randomized clinical trial is warranted.

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