Key result
Adding respiratory muscle training to hybrid cardiac rehabilitation fails to improve 6-minute walk distance.
Why the study?
Cardiac surgery can reduce pulmonary function, respiratory muscle strength, and functional capacity, but evidence regarding respiratory muscle training within hybrid cardiac rehabilitation remains limited.
Does adding respiratory muscle training to hybrid cardiac rehabilitation improve pulmonary function, respiratory muscle strength, and functional capacity in patients following cardiac surgery?
RCT (n=20)
randomized
Does adding respiratory muscle training to hybrid cardiac rehabilitation improve pulmonary function, respiratory muscle strength, and functional capacity in patients following cardiac surgery?
Absolute Event Rate: 55.5% vs 49.5%
p-value: p=>0.05
Adding respiratory muscle training to hybrid cardiac rehabilitation after cardiac surgery is safe and feasible but provides no additional short-term benefit over hybrid cardiac rehabilitation alone.
Does not enhance post-surgical functional capacity; challenges routine addition to hybrid cardiac rehabilitation protocols.
BACKGROUND: Cardiac surgery may reduce pulmonary function, respiratory muscle strength, and functional capacity after surgery. Respiratory muscle training (RMT) is recommended in cardiac rehabilitation; however, evidence regarding RMT within HCR remains limited. OBJECTIVE: To evaluate the effects of adding RMT to an HCR program following cardiac surgery in a randomized controlled trial. METHODS: In this randomized controlled trial, 20 patients were randomized to HCR (n=10) or HCR+RMT (n=10). Rehabilitation started in postoperative week 1 and continued for 8 weeks. Both groups received HCR, while the HCR+RMT group performed combined inspiratory and expiratory muscle training. Primary outcomes were pulmonary function, respiratory muscle strength, and 6-minute walk distance. Secondary outcomes included quality of life, physical activity, usability, feasibility, and satisfaction. RESULTS: Twenty participants completed the study, with 100% retention and attendance in both groups and no adverse events. At postoperative week 1, respiratory and functional parameters declined in both groups. By week 8, 6-minute walk distance increased by 49.5 m in the HCR group and 55.5 m in the HCR+RMT group. Duke Activity Status Index scores improved by 5.25 and 4.95 points, respectively, while Minnesota Living with Heart Failure Questionnaire scores decreased by 7-9 points. No significant between-group differences were found for any outcome (all p>0.05). CONCLUSIONS: Adding RMT to HCR is feasible, safe, and well accepted. Both interventions improved respiratory function, respiratory muscle strength, functional capacity, physical activity, and quality of life. Although no additional short-term benefit was observed with RMT, it may be considered complementary to HCR programs. CLINICAL TRIAL REGISTRATION NUMBER: NCT06258681.
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Ekşi et al. (2026) conducted an RCT in post-cardiac surgery (n=20). Respiratory muscle training (RMT) vs. Hybrid cardiac rehabilitation (HCR) alone was evaluated on pulmonary function, respiratory muscle strength, and 6-minute walk distance (p=>0.05). Adding respiratory muscle training to hybrid cardiac rehabilitation following cardiac surgery did not significantly improve 6-minute walk distance (55.5 m vs 49.5 m increase; p>0.05).
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