Inspiratory Muscle Training in Patients in the Postoperative Phase of Cardiac Surgery: A Systematic Review and Meta-Analysis.

To review the evidence about inspiratory muscle training (IMT) in patients in postoperative of cardiac surgery. We conducted this systematic review used the databases Ovid, LILACS, CINAHL, PubMed, PEDro, and CENTRAL. Randomized clinical trials that addressed IMT after cardiac surgery were selected. The outcomes assessed were maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), tidal volume (TV), peak expiratory flow (PEF), functional capacity (6-minute walk test) and length of hospital stay. The mean difference between groups and the respective 95% confidence interval (CI) were calculated and used to quantify the effect of continuous outcomes. Seven studies were selected. The IMT was superior to the control over MIP 15.77 cmH2O (95% CI, 5.95-25.49), MEP 15.87 cmH2O (95% CI, 1.16-30.58), PEF 40.98 L/min (95% CI, 4.64-77.32), TV 184.75 mL (95% CI, 19.72-349.77), hospital stay -1.25 days (95% CI, -1.77 to -0.72), but without impact on functional capacity 29.93 m (95% CI, -27.59 to 87.45). Based on the results presented, IMT was beneficial as a form of treatment for patients after cardiac surgery.

Cardiovascular Risk Factors, Functionality, and Quality of Life in Climacteric Women

Abstract Background: Cardiovascular disease (CVD) comprises a group of cardiac and circulatory diseases. Despite the high incidence in males, women after menopause have an exponential increase in the risk of CVD. Objective: To identify the leading risk factors for CVD and describe quality of life and functionality in women hospitalized for cardiac causes during the climacteric period. Materials and methods: Observational descriptive study. Quality of life was assessed through the SF-36 questionnaire, and functionality through the Functional Independence Measurement (FIM) scale. Records were used to identify the main risk factors associated with CVD in climacteric women. Results: We included 30 patients (mean age, 55 ± 6 years). The mean FIM score was 118 ± 3, and the mean SF-36 score, 20 ± 10. Hypertension and sedentary lifestyle were the most prevalent cardiovascular risk factors in these women. Conclusion: Hypertension and sedentary lifestyle were the most prevalent cardiovascular risk factors in this sample of climacteric women hospitalized for cardiac causes. Quality of life was strongly affected, with social, emotional, and mental health domains showing the most impact.

Two types of inspiratory muscle training on muscle strength in patients submitted to coronary artery bypass grafting: clinical trial / Dois tipos de treinamento muscular inspiratório sobre a força muscular de pacientes após revascularização do miocárdio: ensaio clínico

Introduction: Coronary artery bypass grafting (CABG) causes changes in the respiratory musculature that affects functional capacity and postoperative complications (POC). Inspiratory muscle training (IMT) is a tool used for these patients, but it is not known what the best form is to increase strength. Objective: To investigate whether IMT with a linear pressure load device is superior to the inspiratory incentive on functional capacity and muscle strength of patients undergoing CABG. Methods: This is a clinical trial. Patients were assessed preoperatively for inspiratory muscle pressure (MIP), expiratory pressure (MEP), peak expiratory flow (PEF), six-minute walk test (6MWT) and functional independence measure (FIM). After surgery, they were divided into three groups: control group (CG), training group with linear pressure load (IMT) and inspiratory incentive group (IG). On the day of discharge, all patients had their previous variables reassessed. Results: The study included 56 patients, 31 (55.4%) were male and an average age of 55 ± 12 years. There was a significant reduction in all variables, in relation to MIP, the IMT showed a higher value in the postoperative period 83 ± 19 cmH2O, against 70 ± 15 cmH2O in the CG and 80 ± 15 cmH2O in the IG (p < 0.001). The same behavior was observed in MEP, 77 ± 12 cm H2O in IMT, 67 ± 14 cmH2O in CG and 75 ± 10 cmH2O in IG (p < 0.001). Regarding the 6 MWT, there was a lesser loss in the IMT from 434 ± 15 m to 398 ± 20 m in IG (p < 0.001). Conclusion: It is concluded that muscle training with a linear pressure load device is superior to training with incentive on functional capacity and muscle strength in patients undergoing CABG. (AU)

Introdução: A cirurgia de revascularização do miocárdio (CRM) causa alterações na musculatura respiratória que afetam a capacidade funcional e complicações pós-operatórias (DCP). O treinamento muscular inspiratório (TMI) é uma ferramenta utilizada por esses pacientes, mas não se sabe qual é a melhor forma de aumentar a força. Objetivo: Investigar se o TMI com dispositivo de carga de pressão linear é superior ao incentivo inspiratório na capacidade funcional e força muscular de pacientes submetidos à CRM. Métodos: Este é um ensaio clínico. Os pacientes foram avaliados no pré-operatório para pressão muscular inspiratória (PImáx), pressão expiratória (PEF), pico de fluxo expiratório (PFE), teste de caminhada de seis minutos (TC6) e medida de independência funcional (MIF). Após a cirurgia, eles foram divididos em três grupos: grupo controle (GC), grupo treinamento com carga linear de pressão (IMT) e grupo incentivo inspiratório (GI). No dia da alta, todos os pacientes tiveram suas variáveis anteriores reavaliadas. Resultados: O estudo incluiu 56 pacientes, 31 (55,4%) eram do sexo masculino e idade média de 55 ± 12 anos. Houve redução significativa em todas as variáveis, em relação à PImáx, o IMT apresentou valor maior no pós-operatório 83 ± 19 cmH2O, contra 70 ± 15 cmH2O no GC e 80 ± 15 cmH2O no GI (p < 0,001). O mesmo comportamento foi observado na PEmáx, 77 ± 12 cmH2O no IMT, 67 ± 14 cmH2O no GC e 75 ± 10 cmH2O no GI (p < 0,001). Em relação ao TC6, houve menor perda no TMI de 434 ± 15 metros para 398 ± 20 metros no GI (p < 0,001). Conclusão: Conclui-se que o treinamento muscular com dispositivo de carga pressórica linear é superior ao treinamento com incentivo inspiratório na capacidade funcional e da força muscular em pacientes submetidos à CRM. (AU)