The influence of positive airway pressure associated with physiotherapy intervention in phase I of cardiac rehabilitation

Objective

The objective of this study was to evaluate the effects of positive expiratory airway pressure and physiotherapy intervention (PI) in phase I of cardiac rehabilitation (PP1) on the behavior of pulmonary function (PF) and inspiratory muscle strength (IMS) in the postoperative (PO) period of cardiac surgery (CS).

Method

Twenty-four patients were randomly assigned into two groups: GEP (n = 8) performed respiratory exercises with positive expiratory pressure (EPAP) associated with PP1; and GP1 (n = 16) performed PP1 only. The PF was measured by spirometry preoperatively and at the fifth PO (5PO), and the IMS was measured by the maximal inspiratory pressure (PImax) pre-operatively, at the first PO (1PO) and at 5PO.

Results

For spirometric variables, as a percentage of predicted, significant reductions were observed when the preoperative was compared with 1PO for GP1, but for GEP only a difference to the vital capacity was observed (P > 0.05). In relation to the differences between the treatments, smaller values were observed in GP1 for peak flow (PFl) at 5PO. We found significant reductions of PImax preoperatively to 1PO in both groups. However, PImax showed a reduction of the preoperative to 5PO situation only in GPI (P < 0.05).

Conclusion

These data suggest that CS produces reductions of IMS and PF, and that EPAP associated with PP1 was more effective in the reduction of respiratory changes than PP1 isolated. However, the PF did not wholly reverse until 5PO, the continuance of treatments being necessary after this hospital period.