Efeito do treinamento muscular inspiratório na função pulmonar e na capacidade funcional de pacientes submetidos à cirurgia cardíaca

Abstract

Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality in the world, considered a serious public health problem. Cardiac surgery (CC) is a treatment indicated for patients with CVDs, as the goal of symptom relief and better prognosis of these individuals. However, the surgery can cause a series of complications in the postoperative period, where patients experience a functional decline, which may be caused by pulmonary complications. Inspiratory muscle training (IMT) promotes beneficial effects in patients undergoing CC, however there is no consensus on pulmonary function and functional capacity. Thus, the aim of this study was to evaluate the effects of IMT on pulmonary function and functional capacity of patients undergoing CC. A clinical trial was performed in patients submitted to CC, coming from the University Hospital of Santa Maria. The patients were divided into 2 groups: control group (CG) (10), submitted to conventional physical therapy, which consisted of stretching, kinesiotherapy and ventilatory patterns, once a day; and inspiratory muscle training group (IMTG) (12), submitted to conventional physical therapy such as CG, added to IMT. The IMT was performed twice a day, 3 sets of 10 repetitions, inspiratory load of 30% of the preoperative maximum inspiratory pressure (MIP) (POP) using the Threshold® IMT device. Patients were assessed for pulmonary function by spirometry and functional capacity by means of the 6-min walk distance (6MWD). Variables were compared by two-way ANOVA for repeated measures, followed by Bonferroni post hoc. Significant reduction in pulmonary function variables (FVC, FEV1, FEV1 / FVC) was observed when POP was compared with the first postoperative day (PO1). When the 7th postoperative day (PO7) was compared with PO1, there was an increase in pulmonary function variables (FVC, FEV1, FEV1 / FVC). When compared to 6MWD between POP and PO7, there was a decrease in both groups. Thus, we found that patients undergoing CC had impaired pulmonary function and functional capacity. In addition, no difference was shown between CG and IMTG, however, IMT was effective in recovering variables in the trained group.