Determination of the Effectiveness of Physiotherapy Techniques after Coronary Artery Bypass Graft Surgery

Öz

Objective: The aim of this study was to investigate the effects of incentive spirometer on respiratory muscle strength, exercise capacity and hemodynamic responses after CABG surgery. Methods: Between June 2017 and December 2018, a total of 35 patients underwent CABG surgery were included this prospective randomized controlled study. Patients divided into incentive spirometer (IS) group and physiotherapy (PT) group. All patients received standard physiotherapy postoperatively. In addition, IS group received volume-oriented incentive spirometer. Respiratory muscle strength (mouth pressure device) on 2nd and 5th postoperative day, exercise capacity (6-min.walking test (6-MWT)) on 3rd postoperative day, before and immediately after physiotherapy on the first post-operative day blood gases were assessed. Results: Demographic characteristics of the groups were similar in both groups. Statistically significant increases in maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), %MIP and %MEP values were observed in both two groups (p<0.05) but there was no statistically significant difference between the groups (p > 0.05). There were no significant differences in 6 MWT parameters between PT and IS group (p > 0.05). No significant difference was found in arterial blood gas values on first postoperative day in both groups (p > 0.05). Conclusion: Respiratory muscle strength improved and blood gas values maintained in both groups. There was no superiority of IS combined with PT in increasing respiratory muscle strength and in maintaining arterial blood gas results after CABG surgery. IS combined with physiotherapy could be used safely from the early period after cardiac surgery.

Anahtar Kelimeler

• Coronary artery bypass graft surgery
• physiotherapy
• exercise capacity

Koroner Arter Bypass Greft Cerrahisi sonrası Fizyoterapi Programlarının Etkinliğinin Belirlenmesi

Öz

Amaç: Bu çalışmanın amacı, koroner arter bypass greft (KABG) cerrahisi sonrası insentif spirometrenin solunum kas gücü, egzersiz kapasitesi ve hemodinamik yanıtlar üzerine etkilerini araştırmaktı. Yöntem: Haziran 2017 ve Aralık 2018 arasında KABG ameliyatı geçiren toplam 35 hasta bu prospektif randomize kontrollü çalışmaya dâhil edildi. Hastalar insentif spirometre (IS) ve fizyoterapi (PT) gruplarına ayrıldı. Tüm hastalara postoperatif standart fizyoterapi uygulandı. Ayrıca, IS grubuna volüm duyarlı insentif spirometre verildi. Solunum kas kuvveti (ağız basıncı cihazı) postoperatif 2. ve 5. günlerde, egzersiz kapasitesi (6-dakika yürüme testi (6-DYT)) postoperatif 3. günde, kan gazları ameliyat sonrası ilk gün fizyoterapiden önce ve hemen sonra değerlendirdi. Sonuçlar: Grupların demografik özellikleri her iki grupta benzerdi. Her iki grupta da maksimal inspiratuar basınç (MIP), maksimal ekspiratuar basınç (MEP), % MIP ve % MEP değerlerinde istatistiksel olarak anlamlı artış gözlendi (p <0.05) ancak gruplar arasında istatistiksel olarak anlamlı fark yoktu (p> 0.05). PT ve IS grubu arasında 6 DYT parametrelerinde anlamlı fark yoktu (p> 0.05). Her iki grupta postoperatif birinci gün arteriyel kan gazı değerlerinde anlamlı fark bulunmadı (p> 0.05). Sonuç: Her iki grupta da solunum kas kuvveti düzeldi ve kan gazı değerleri korundu. KABG ameliyatından sonra IS ile kombine edilmiş fizyoterapinin, solunum kas kuvvetinin artmasında ve arteriyel kan gazı sonuçlarının korunmasında üstünlüğü yoktu. Fizyoterapi ile kombine edilen IS, kalp cerrahisi sonrası erken dönemden itibaren güvenle kullanılabilir.

Anahtar Kelimeler

• Koroner arter bypass greft cerrahisi
• fizyoterapi
• egzersiz kapasitesi

Kaynakça

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