Inspiratory Muscle Training Based on Anaerobic Threshold on the Functional Capacity of Patients After Coronary Artery Bypass Grafting: Clinical Trial

Abstract

Introduction Coronary artery bypass grafting (CABG) is associated with reduced ventilatory muscle strength and consequent worsening of functional capacity (FC). Inspiratory Muscle Training (IMT) can be indicated, but there is still a lack of knowledge about the use of the anaerobic threshold (AT) as a basis for prescription. The objective of this study is to evaluate if IMT based on AT modifies FC and inspiratory muscle strength of patients submitted to CABG. Methods This is a clinical trial. On the first postoperative day, the patients were divided into two groups: the conventional group (IMT-C), which performed IMT based on 40% of maximal inspiratory pressure (MIP), and the IMT-AT group, which performed IMT based on AT. All patients underwent preoperative and postoperative assessment of MIP and performed a six-minute walk test (6MWT). Results Forty-two patients were evaluated, 21 in each group. Their mean age was 61.4±10 years and 27 (64%) of them were male. There was a reduction of inspiratory muscle strength with a delta of 23±13 cmH2O in the IMT-C group vs . 11±10 cmH2O in the IMT-AT group ( P <0.01) and of the walking distance with a delta of 94±34 meters in the IMT-C group vs . 57±30 meters in the IMT-AT group ( P =0.04). Conclusion IMT based on AT minimized the loss of FC and inspiratory muscle strength of patients submitted to CABG.

Velocidade de marcha e reinternação hospitalar após cirurgia de revascularização do miocárdio

“…Our group demonstrated that after myocardial revascularization it generates a decrease in functional capacity, observed through the six-minute walk test [20]. We found that performing inspiratory muscle training helps to minimize this decline and improve clinical outcomes such as length of hospital stay [20,21].…”

Gait Speed and Hospital Reinternation After Coronary Artery Bypass Grafting

“…Bed restriction time and contributes to physical and functional decline 18,19 . Our group demonstrated that after myocardial revascularization it generates a decrease in functional capacity, observed through the sixminute walk test 20 . We found that performing inspiratory muscle training helps to minimize this decline and improve clinical outcomes such as length of hospital stay 20,21 .…”

Treinamento muscular inspiratório na qualidade de vida e capacidade funcional na cardiotoxicidade: relato de caso

“…Vale destacar que a forma de se prescrever o TMI foi diferente do modelo tradicional. Utilizamos o limiar glicêmico 9 ao invés da porcentagem da pressão inspiratória máxima (PImáx). Isso pode ter impactado no resultado, uma vez que a prescrição baseada no LG parece ser mais precisa e gerar melhores resultados da função diafragmática.…”

“…Isso pode ter impactado no resultado, uma vez que a prescrição baseada no LG parece ser mais precisa e gerar melhores resultados da função diafragmática. Num dos trabalhos desenvolvidos por nosso grupo, observamos que houve menor redução da PImáx em pacientes pós-cirurgia cardíaca que utilizaram o LG dos músculos inspiratórios como base para a prescrição do TMI em comparação aos que utilizaram a PImáx como referência para prescrição 9 . No primeiro grupo a redução da PImáx foi de 12%, enquanto no grupo convencional (prescrição norteada pela PImáx) a redução foi de 32%.…”