Key result
Pre-operative physical therapy incorporating inspiratory muscle training significantly reduced post-operative ICU stay by a mean of 0.84 days (p<0.001) compared to breathing exercises alone in CABG candidates.
Why the study?
The study was conducted to determine the impact of a pre-operative physical therapy plan with inspiratory muscle training on functional capacity, kinesiophobia, and post-operative ICU stay in CAD candidates for CABG.
Does pre-operative inspiratory muscle training combined with breathing exercises and chest clearance techniques improve functional capacity, kinesiophobia, and ICU stay in CAD patients undergoing CABG?
RCT (n=50)
Double-blind
Concealed envelope method
No
Does pre-operative inspiratory muscle training combined with breathing exercises and chest clearance techniques improve functional capacity, kinesiophobia, and ICU stay in CAD patients undergoing CABG?
Mean Difference: 0.84
Absolute Event Rate: 1.76% vs 2.6%
p-value: p=<0.001
Pre-operative inspiratory muscle training significantly improves functional capacity, reduces kinesiophobia, and shortens ICU stay in patients undergoing coronary artery bypass grafting.
Supports pre-operative IMT before CABG to shorten ICU stay and improve functional capacity; extends RCT evidence for respiratory prehab in cardiac surgery.
Objectives: This study was done to find out the impact of a pre-operative physical therapy plan with inspiratory muscle training on functional capacity, kinesiophobia, and post-operative intensive care unit (ICU) stay in subjects with coronary artery disease (CAD) candidates for coronary artery bypass grafting (CABG). Methods: Fifty subjects who fulfilled the inclusion criteria were recruited and randomly distributed into the intervention and control group by concealed envelop method. Participants in the experimental group were provided with inspiratory muscle training (IMT) with breathing exercises and chest clearance techniques, while the control group received breathing exercises and chest clearance techniques. Both groups received three treatment sessions before their scheduled surgery. The assessment was done at three-time intervals: At baseline, after three sessions, and after surgery. The outcome measures were oxygen saturation, heart rate, respiratory rate, Borg scale of perceived exertion (Borg PRE), Tampa scale of kinesiophobia for the heart (TSKH), and days spent at ICU after CABG. Results: Oxygen saturation, respiratory rate, functional capacity, and pulmonary endurance improved significantly among the treatment groups with a P<0.001 and a large effect size. The pulse rate showed no significant improvement; P and effect size were 0.38 and 0.60, respectively. Kinesiophobia and ICU stay also showed significant changes with a P<0.001. The effect size was large for both kinesiophobia and ICU stay. Discussion: IMT as a component of a pre-operative physical therapy plan can improve oxygen saturation, respiratory rate, functional capacity, and pulmonary endurance in CAD patients going for CABG. IMT reduces the level of kinesiophobia and duration of ICU stay after CABG.
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Khushnood et al. (2023) conducted an RCT in Coronary artery disease (CAD) candidates for coronary artery bypass grafting (CABG) (n=50). Pre-operative physical therapy with inspiratory muscle training (IMT), breathing exercises, and chest clearance techniques vs. Breathing exercises and chest clearance techniques was evaluated on Post-operative ICU stay (days) (MD 0.84, p=<0.001). Pre-operative physical therapy incorporating inspiratory muscle training significantly reduced post-operative ICU stay by a mean of 0.84 days (p<0.001) compared to breathing exercises alone in CABG candidates.
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