Adding combined respiratory muscle training to hybrid cardiac rehabilitation after cardiac surgery yielded similar improvements across all measured outcomes as rehabilitation alone (p>0.05).
RCT (n=20)
randomly assigned
Does adding combined inspiratory and expiratory muscle training to hybrid cardiac rehabilitation improve respiratory function, functional capacity, and quality of life in individuals after cardiac surgery?
Adding targeted respiratory muscle training to an 8-week hybrid cardiac rehabilitation program after cardiac surgery did not yield additional improvements in respiratory function, functional capacity, or quality of life compared to standard hybrid cardiac rehabilitation.
p-value: p=>0.05
Abstract Introduction Hybrid cardiac rehabilitation (HCR) enhances accessibility and adherence through the combination of in-person and remote sessions. Previous research suggests that incorporating inspiratory and expiratory respiratory muscle training (RMT) into HCR may help mitigate postoperative reductions in respiratory muscle strength and lung volumes. Purpose This study aims to evaluate the effects of a combined HCR program including inspiratory and expiratory RMT on respiratory function, respiratory muscle strength, functional capacity, and quality of life in individuals after cardiac surgery. Methods Twenty participants were randomly assigned to the HCR or HCR+RMT group. The eight-week HCR program included two weeks of supervised in-person sessions and six weeks of real-time remotely supervised sessions. Respiratory function (FEV1, FVC), respiratory muscle strength (MIP, MEP), and functional capacity (6-minute walk distance) were assessed at three time points: preoperatively, postoperative week 1, and postoperative week 8. Physical activity level (Duke Activity Status Index, DASI) and quality of life (Minnesota Living with Heart Failure Questionnaire, MLHFQ) were evaluated only at preoperative assessment and postoperative week 8. In both groups, respiratory exercises were included as part of the HCR program. In the HCR+RMT group, the program included combined inspiratory and expiratory muscle training using a device set at 40–60% of maximal inspiratory and expiratory pressures. Results The results are summarized in Table 1 and Table 2. At postoperative week 1, decreases were observed in respiratory function, respiratory muscle strength, and functional capacity in both groups compared with preoperative values. By postoperative week 8, all of these parameters demonstrated significant within-group increases relative to baseline (p0.05). Physical activity level and quality of life scores also showed significant improvements at postoperative week 8, and marked increases were noted in VO2peak and MET levels (p0.001). No significant between-group differences or group×time interaction effects were identified for any of the measured outcomes (p0.05). Conclusion In this study, both HCR and HCR+RMT resulted in similar improvements in respiratory function, respiratory muscle strength, functional capacity, physical activity level, and quality of life. Within the current protocol, both approaches appear to yield similar short-term benefits, supporting the clinical applicability of combined respiratory training as part of comprehensive HCR after cardiac surgery.For image description, please refer to the figure legend and surrounding text. For image description, please refer to the figure legend and surrounding text.
Eksi et al. (Mon,) conducted a rct in post-cardiac surgery (n=20). Combined inspiratory and expiratory respiratory muscle training (RMT) vs. Hybrid cardiac rehabilitation (HCR) alone was evaluated on Respiratory function, respiratory muscle strength, functional capacity, physical activity level, and quality of life (p=>0.05). Adding combined respiratory muscle training to hybrid cardiac rehabilitation after cardiac surgery yielded similar improvements across all measured outcomes as rehabilitation alone (p>0.05).