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Deep Breathing Exercises Performed 2 Months Following Cardiac Surgery: A Randomized Controlled Trial
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
Örebro universitetssjukhus.
Örebro Universitet.
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2014 (English)In: JOURNAL OF CARDIOPULMONARY REHABILITATION AND PREVENTION, ISSN 1932-7501, Vol. 34, no 1, 34-42 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Postoperative breathing exercises are recommended to cardiac surgery patients. Instructions concerning how long patients should continue exercises after discharge vary, and the significance of treatment needs to be determined. Our aim was to assess the effects of home-based deep breathing exercises performed with a positive expiratory pressure device for 2 months following cardiac surgery. METHODS: The study design was a prospective, single-blinded, parallel-group, randomized trial. Patients performing breathing exercises 2 months after cardiac surgery (n = 159) were compared with a control group (n = 154) performing no breathing exercises after discharge. The intervention consisted of 30 slow deep breaths performed with a positive expiratory pressure device (10-15 cm H2O), 5 times a day, during the first 2 months after surgery. The outcomes were lung function measurements, oxygen saturation, thoracic excursion mobility, subjective perception of breathing and pain, patient-perceived quality of recovery (40-Item Quality of Recovery score), health-related quality of life (36-Item Short Form Health Survey), and self-reported respiratory tract infection/pneumonia and antibiotic treatment. RESULTS: Two months postoperatively, the patients had significantly reduced lung function, with a mean decrease in forced expiratory volume in 1 second to 93 +/- 12% (P< .001) of preoperative values. Oxygenation had returned to preoperative values, and 5 of 8 aspects in the 36-Item Short Form Health Survey were improved compared with preoperative values (P< .01). There were no significant differences between the groups in any of the measured outcomes. CONCLUSION: No significant differences in lung function, subjective perceptions, or quality of life were found between patients performing home-based deep breathing exercises and control patients 2 months after cardiac surgery.

Place, publisher, year, edition, pages
2014. Vol. 34, no 1, 34-42 p.
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
URN: urn:nbn:se:uu:diva-190789DOI: 10.1097/HCR.0000000000000020ISI: 000335569100005OAI: oai:DiVA.org:uu-190789DiVA: diva2:589161
Available from: 2013-01-17 Created: 2013-01-08 Last updated: 2014-07-02Bibliographically approved
In thesis
1. Lung Function, Respiratory Muscle Strength and Effects of Breathing Exercises in Cardiac Surgery Patients
Open this publication in new window or tab >>Lung Function, Respiratory Muscle Strength and Effects of Breathing Exercises in Cardiac Surgery Patients
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Breathing exercises are widely used after cardiac surgery. The duration of exercises in the immediate postoperative period is not fully evaluated and only limited data regarding the effects of home-based breathing exercises after discharge from hospital have been published.

Aim: The overall aim of this thesis was to evaluate the effects of deep breathing exercises with positive expiratory pressure (PEP) and describe lung function and respiratory muscle strength in patients undergoing cardiac surgery.

Participants and settings: Adult participants (n=131) were randomised to perform either 30 or 10 deep breaths with PEP per hour during the first postoperative days (Study I): the main outcome was oxygenation, assessed by arterial blood gases, on the second postoperative day. In Study III, 313 adult participants were randomly assigned to perform home-based deep breathing exercises with PEP for two months after surgery or not to perform breathing exercises with PEP after the fourth to fifth postoperative day. The main outcome was lung function, assessed by spirometry, two months after surgery. Studies II and IV were descriptive and correlative and investigated pre and postoperative lung function, assessed by spirometry, and respiratory muscle strength, assessed by maximal inspiratory pressure, and maximal expiratory pressure.

Results: On the second postoperative day, arterial oxygen tension (PaO2) and arterial oxygen saturation (SaO2) was higher in the group randomised to 30 deep breaths with PEP hourly. There was no improved recovery of lung function in participants performing home-based deep breathing exercises two months after cardiac surgery, compared to a control group. Subjective experience of breathing or improvement in patient perceived quality of recovery or health-related quality of life did not differ between the groups at two months. Lung function and respiratory muscle strength were in accordance with predicted values before surgery. A 50% reduction in lung function was shown on the second postoperative day. High body mass index, male gender and sternal pain were associated with decreased lung function on the second postoperative day. Two months postoperatively, there was decreased lung function, but respiratory muscle strength had almost recovered to preoperative values.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 58 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 857
Keyword
Breathing exercises, Cardiac surgery, Deep breathing, Lung function, Oxygenation, Physical therapy, Positive expiratory pressure, Spirometry, Respiratory muscle strength
National Category
Physiotherapy
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-192208 (URN)978-91-554-8580-1 (ISBN)
Public defence
2013-03-01, B:42, BMC, Husargatan 3, Uppsala, 09:15 (Swedish)
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Note

Available from: 2013-02-08 Created: 2013-01-17 Last updated: 2013-02-14

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Westerdahl, ElisabethUrell, CharlotteHedenström, HansEmtner, Margareta

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