Key result
Adding incentive spirometry to cardiac rehab fails to reduce hospital stay or improve recovery.
Why the study?
The effects of adding incentive spirometry to hospital-based cardiac rehabilitation on postoperative pulmonary complications, functional recovery, and hospital length of stay after cardiac surgery were not determined.
Does adding incentive spirometry to cardiac rehabilitation improve functional recovery or reduce pulmonary complications in patients undergoing cardiac surgery?
RCT (n=46)
Single-blind (outcome assessors blinded)
Randomized through the website http://www.randomization.com
Yes
Does adding incentive spirometry to cardiac rehabilitation improve functional recovery or reduce pulmonary complications in patients undergoing cardiac surgery?
Mean Difference: -1 (95% CI -4.71–2.71)
Absolute Event Rate: 9% vs 10%
p-value: p=0.678
The routine addition of incentive spirometry to a structured cardiac rehabilitation program does not confer additional clinical benefits for functional recovery or reducing pulmonary complications after cardiac surgery.
No added benefit from incentive spirometry after cardiac surgery; challenges routine addition and supports cardiac rehabilitation alone in protocols.
Background and Purpose This study investigated the effects of combining incentive spirometry with cardiac rehabilitation compared with cardiac rehabilitation alone on postoperative pulmonary complications, clinical‐functional recovery, and hospital length of stay in patients undergoing cardiac surgery. Methods Randomized controlled trial was conducted from May 2019 to October 2023 in two hospitals, including 46 inpatients undergoing cardiac surgery. Participants were assigned to incentive spirometry plus cardiac rehabilitation or cardiac rehabilitation alone. Both interventions were performed twice daily; spirometry used a volume‐oriented device, and rehabilitation followed a seven‐step protocol (2–4 METs). Outcomes included postoperative pulmonary complications, functional capacity (6‐min walk test), handgrip strength, respiratory muscle function, and length of hospital stay. Results The incentive spirometry associated with cardiac rehabilitation group had a longer extracorporeal circulation time (98 ± 26 min) than the cardiac rehabilitation group (76 ± 1; p = 0.008). Both groups showed a postoperative decline in respiratory muscle strength, and walking distance (MD: −64.37 m; 95% CI: [−24.1; −104.6]; d = 0.71), with no difference in postoperative pulmonary complications and handgrip strength. The incentive spirometry associated with cardiac rehabilitation group did not significantly differ on postoperative hospital stay compared with the cardiac rehabilitation group (MD: −1 day; 95% CI: [−4.71; 2.71]; d = −0.19). Conclusions In this study, no additional benefit was observed with the addition of incentive spirometry to cardiac rehabilitation compared with cardiac rehabilitation alone. No significant differences were detected between groups in postoperative pulmonary complications, hospital length of stay, or clinical‐functional recovery among individuals undergoing cardiac surgery. Trial Registration Brazilian Registry of Clinical Trials (REBEC) under the number RBR‐8tsjf97
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Messias et al. (2026) conducted an RCT in Cardiac surgery (CABG and/or valve replacement) (n=46). Incentive spirometry combined with cardiac rehabilitation vs. Cardiac rehabilitation alone was evaluated on Postoperative hospital stay (MD -1 day, 95% CI -4.71 to 2.71, p=0.678). Adding incentive spirometry to cardiac rehabilitation did not significantly reduce postoperative hospital stay (MD -1 day) or improve functional recovery compared to cardiac rehabilitation alone.
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