Ann Rehabil Med.  2023 Jun;47(3):162-172. 10.5535/arm.23022.

Inspiratory Muscle Training in Patients in the Postoperative Phase of Cardiac Surgery: A Systematic Review and Meta-Analysis

• Cordeiro ALL
• Soares LO
• Gomes-Neto M
• Petto J

• KMID: 2543413
• DOI: http://doi.org/10.5535/arm.23022

Abstract

To review the evidence about inspiratory muscle training (IMT) in patients in postoperative of cardiac surgery. We conducted this systematic review used the databases Ovid, LILACS, CINAHL, PubMed, PEDro, and CENTRAL. Randomized clinical trials that addressed IMT after cardiac surgery were selected. The outcomes assessed were maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), tidal volume (TV), peak expiratory flow (PEF), functional capacity (6-minute walk test) and length of hospital stay. The mean difference between groups and the respective 95% confidence interval (CI) were calculated and used to quantify the effect of continuous outcomes. Seven studies were selected. The IMT was superior to the control over MIP 15.77 cmH2O (95% CI, 5.95–25.49), MEP 15.87 cmH2O (95% CI, 1.16–30.58), PEF 40.98 L/min (95% CI, 4.64–77.32), TV 184.75 mL (95% CI, 19.72–349.77), hospital stay -1.25 days (95% CI, -1.77 to -0.72), but without impact on functional capacity 29.93 m (95% CI, -27.59 to 87.45). Based on the results presented, IMT was beneficial as a form of treatment for patients after cardiac surgery.

Keyword

Myocardial revascularization; Breathing exercise; Pulmonary function tests; Exercise

Figure

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  Fig. 1. Selection process for studies included in the analysis.

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  Fig. 2. Forest plot of the results of the meta-analysis. (A) Comparison of the inspiratory muscle training (IMT) with the control over the maximum inspiratory pressure outcome. The values presented are the average effects (difference between the means) and a 95% confidence interval (CI). The average effect was calculated using a random-effect model. (B) Comparison of the IMT with the control over the maximum expiratory pressure outcome. The values presented are the average effects (difference between the means) and a 95% CI. The average effect was calculated using a random-effect model. (C) Comparison of IMT with control over peak expiratory flow outcome. The values presented are the average effects (difference between the means) and a 95% CI. The average effect was calculated using a random-effect model. (D) Comparison of the IMT with the control over the tidal volume outcome. The values presented are the average effects (difference between the means) and a 95% CI. The average effect was calculated using a random-effect model. (E) Comparison of the IMT with the control over the functional capacity outcome. The values presented are the average effects (difference between the means) and a 95% CI. The average effect was calculated using a random-effect model. (F) Comparison of the IMT with the control over the outcome length of hospital stay. The values presented are the average effects (difference between the means) and a 95% CI. The average effect was calculated using a random-effect model. SD, standard deviation.

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