Contrasting effects of three breathing techniques on pulmonary function, functional capacity and daily life functional tasks in patients following valve replacement surgery- A pilot randomized clinical trial

Abstract

Background Valve replacement surgeries affect the physiological mechanisms of patients leading to various postoperative pulmonary complications. Lung expansion therapy consisting of numerous techniques is routinely used for the prevention and treatment of these complications. Objectives Our study aimed to compare the effects of diaphragmatic breathing (DB), flow (FS) and volume-oriented incentive spirometer (VS) in patients following valve replacement surgery. Methods 29 patients posted valve replacement surgeries were randomly assigned to VS, FS and DB groups. Patients underwent preoperative training and seven-day rehabilitation post-surgery. Pulmonary function tests were performed before surgery and for seven days afterward. On the seventh postoperative day, patients performed a six-minute walk test and completed a functional difficulties questionnaire (FDQ). Results Pulmonary function test values reduced in all three groups postoperatively when compared to the preoperative values but improved by the seventh postoperative day (p < 0.05). On comparing the seventh postoperative day values to the preoperative values, the VS group had no significant difference (p = 1.00) (Forced Vital Capacity- % change: DB-37.76, VS-1.59, FS-27.98), indicating that the value had nearly returned to the baseline. As compared to the DB and FS groups, FVC showed a greater improvement in the VS group (p = 0.01 and p = 0.06 respectively). No significant differences were observed between groups for distance walked (p > 0.05), however, FDQ scores demonstrated positive changes in favor of VS when contrasted with FS or DB (p < 0.05). Conclusion Diaphragmatic breathing, flow or volume-oriented spirometer could improve pulmonary function in the postoperative period. The volume-oriented spirometer, however, was found to be the most beneficial among the three techniques in improving patients’ pulmonary function and daily life functional tasks. Further research is warranted to confirm these findings.

Volume Incentive Spirometry Reduces Pulmonary Complications in Patients After Open Abdominal Surgery: A Randomized Clinical Trial

“…They were asked to relax their shoulders and upper chest so they could feel the rise and fall of their abdomen with the hand resting on it. 15 The method of performing diaphragmatic breathing exercises is shown in Figure 2A . The exercises were performed for 5 minutes and 4 times per day under the supervision of the therapist.…”

Breathing Exercise untuk Meningkatkan Fungsi Respirasi pada Pasien Pasca Pembedahan Abdomen

“…Adapun hasil studi yang dilakukan oleh Alaparthi et al, (2021) tiga teknik latihan pernapasan meningkatkan fungsi paru pada fase pasca pembedahan. Tiga jenis latihan pernapasan yang diterapkan adalah latihan napas diafragma, latihan pernapasan menggunakan flow incentive spirometry dan volume oriented by incentive spirometry.…”

“…Dari ketiga jenis latihan yang diberikan, kelompok yang mendapatkan latihan pernapasan menggunakan incentive spirometer menunjukkan perkembangan yang lebih baik pada fungsi paru. Hasil ini menunjukkan bahwa latihan menggunakan alat volume spirometer merupakan pilihan tepat untuk meningkatkan fungsi paru pada pasien yang menjalani pembedahan thorakoabdominal (Alaparthi et al, 2021). Pada kelompok perokok, hasil studi menunjukkan bahwa pengaruh latihan otot pernapasan lebih efektif dibandingkan dengan terapi konvensional pada perokok yang menjalani pembedahan abdomen terbuka (Khyati et al, 2020).…”