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Fortes JVS1, Borges DL1, Vale TFS1, Borges MGB1, Lima RO1, Bernardo-Filho M2, Figueiredo Neto JA3
1University Hospital of the Federal University of Maranhão, Cardiovascular ICU, São Luis, Brazil, 2Rio de Janeiro State University, Department of Biophysics and Biometrics, Rio de Janeiro, Brazil, 3Federal University of Maranhão, São Luis, Brazil
Background: Patients undergoing cardiac surgery present impairment in functional parameters, including pulmonary function, respiratory and peripheral muscle strength and functional capacity. Whole body vibration exercises (WBVE) have been studied in several clinical conditions and demonstrated benefits in musculoskeletal and respiratory systems. However, the effects of WBVE in cardiac rehabilitation, especially in phase I, remain unknown.
Purpose: To investigate the effects of WBVE on functional capacity, respiratory and peripheral muscle strength and pulmonary function in patients that have undergone cardiac surgery.
Methods: Thirty patients that have undergone cardiac surgery were randomized to vibration group (WBVE, n =15) or usual care group (Control, n =15). Both groups received the same physiotherapy protocol during phase I of cardiac rehabilitation, after Intensive Care Unit discharge (limbs exercises, walking, and chest physiotherapy). Vibration group received additionally two daily sessions of WBVE. Patients stood with 15° bended knees on the side-alternating oscillating/vibratory platform. Initially, they performed three sets of 1 min (per 1 min rest) at 5 Hz and 8 mm peak-to-peak amplitude, twice a day. Each day, the sessions were improved by one set, and the frequency by 1 Hz, achieving at maximum seven sets of 1 min and 9 Hz, on the 7th postoperative day. Both groups were assessed preoperatively and on the 7th postoperative day, through: (i) pulmonary function, by spirometry; (ii) respiratory muscle strength, by manovacuometry; (iii) peripheral muscle strength, by hand grip dynamometer; (iv) functional capacity, by timed up and go test (TUG). For statistical analyses were applied Shapiro-Wilk, Mann-Whitney, Wilcoxon, Student's t and Fisher exact tests. Results with p 0.05 were considered significant.
Results: WBVE induced the maintenance of vital forced capacity [71(61;79)% vs. 53 (51;65)% p = 0.12] and expiratory peak flow [232 (143;374) L/min vs. 247 (180;280) L/min, p = 0.97]; maximal inspiratory pressure [- 70 (-62;-109) cmH2O vs. -61 (-47; -79) cmH2O, p = 0.16] and maximal expiratory pressure [73 (54;85) cmH2O vs. 64 (57;72) cmH2O, p = 0.15]; handgrip strength [dominant hand - 26 (24;31) kgf vs. 24 (19;33) kgf, p = 0.18; no-dominant hand - 22 (19;29) kgf vs. 21 (17;26) kgf, p = 0.27]; and functional capacity [10 (9;13) seconds vs. 12 (8;13) seconds, p =0.31]. Control group had worst values of assessed outcomes as expected, considering dysfunction related to cardiac surgical procedures.
Conclusion(s): The inclusion of WBVE to a physical therapy protocol after cardiac surgery promotes physiologic responses that contribute to the maintenance of pulmonary function, respiratory and peripheral muscle strength and functional capacity.
Implications: The insertion of vibratory therapy through the oscillating/vibratory platform may be a newly rehabilitation tool for phase I of cardiovascular rehabilitation, after cardiac surgery.
Keywords: Cardiac surgery, Whole body vibration, Physical therapy
Funding acknowledgements: The study was funded by the Maranhão Research Foundation (FAPEMA)
Purpose: To investigate the effects of WBVE on functional capacity, respiratory and peripheral muscle strength and pulmonary function in patients that have undergone cardiac surgery.
Methods: Thirty patients that have undergone cardiac surgery were randomized to vibration group (WBVE, n =15) or usual care group (Control, n =15). Both groups received the same physiotherapy protocol during phase I of cardiac rehabilitation, after Intensive Care Unit discharge (limbs exercises, walking, and chest physiotherapy). Vibration group received additionally two daily sessions of WBVE. Patients stood with 15° bended knees on the side-alternating oscillating/vibratory platform. Initially, they performed three sets of 1 min (per 1 min rest) at 5 Hz and 8 mm peak-to-peak amplitude, twice a day. Each day, the sessions were improved by one set, and the frequency by 1 Hz, achieving at maximum seven sets of 1 min and 9 Hz, on the 7th postoperative day. Both groups were assessed preoperatively and on the 7th postoperative day, through: (i) pulmonary function, by spirometry; (ii) respiratory muscle strength, by manovacuometry; (iii) peripheral muscle strength, by hand grip dynamometer; (iv) functional capacity, by timed up and go test (TUG). For statistical analyses were applied Shapiro-Wilk, Mann-Whitney, Wilcoxon, Student's t and Fisher exact tests. Results with p 0.05 were considered significant.
Results: WBVE induced the maintenance of vital forced capacity [71(61;79)% vs. 53 (51;65)% p = 0.12] and expiratory peak flow [232 (143;374) L/min vs. 247 (180;280) L/min, p = 0.97]; maximal inspiratory pressure [- 70 (-62;-109) cmH2O vs. -61 (-47; -79) cmH2O, p = 0.16] and maximal expiratory pressure [73 (54;85) cmH2O vs. 64 (57;72) cmH2O, p = 0.15]; handgrip strength [dominant hand - 26 (24;31) kgf vs. 24 (19;33) kgf, p = 0.18; no-dominant hand - 22 (19;29) kgf vs. 21 (17;26) kgf, p = 0.27]; and functional capacity [10 (9;13) seconds vs. 12 (8;13) seconds, p =0.31]. Control group had worst values of assessed outcomes as expected, considering dysfunction related to cardiac surgical procedures.
Conclusion(s): The inclusion of WBVE to a physical therapy protocol after cardiac surgery promotes physiologic responses that contribute to the maintenance of pulmonary function, respiratory and peripheral muscle strength and functional capacity.
Implications: The insertion of vibratory therapy through the oscillating/vibratory platform may be a newly rehabilitation tool for phase I of cardiovascular rehabilitation, after cardiac surgery.
Keywords: Cardiac surgery, Whole body vibration, Physical therapy
Funding acknowledgements: The study was funded by the Maranhão Research Foundation (FAPEMA)
Topic: Cardiorespiratory; Disability & rehabilitation
Ethics approval required: Yes
Institution: University Hospital of the Federal University of Maranhão
Ethics committee: Research Ethics Committee
Ethics number: 1554207
All authors, affiliations and abstracts have been published as submitted.
