Thoracic-Abdominal Rebalancing Method is Superior in Terms of Decreasing Respiratory Distress, Postoperative Pulmonary Complications and Hemodynamic Variables When Compared to Conventional Physiotherapy in Postoperative Patients of Coronary Artery Bypass Grafting Surgery: Randomized Clinical Trial.
Karolini Reis Branco, Fernanda Dos Santos Silveira, Letícia Ferronato, Simone Cristina Jabuonski, Vinícius Serra Peringer, Mariangela Pinheiro de Lima, João Paulo Heinzmann-Filho, Bruna Eibel
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引用次数: 0
Abstract
Background and purpose: TAR method recommends reorganizing ventilatory muscle synergism, reducing respiratory effort, removing secretions from the lungs and upper airways, in addition to promoting diaphragmatic juxtaposition and increasing respiratory muscle strength and adjusting muscle tone. However, there are few scientific publications on this method in cardiac patients CABG. To evaluate the effects of the TAR method on hemodynamic variables, respiratory distress and pulmonary complications in patients after CABG surgery.
Methods: This is a single-blind, randomized, clinical trial. Adults (> 35 years old), hemodynamically stable, who had undergone CABG (< 24 h) and with a prescription for physiotherapy were included. Patients were randomized into two groups: IG - TAR; CG-standard physiotherapeutic approach. Interventions were carried out in two days (twice/day), totaling 04 sessions. The following parameters were evaluated pre- and post-intervention: HR, RR, SpO2, MAP, respiratory distress scale. The pulmonary complications scale was applied at the end of the interventions. The sample consisted of 58 patients, 30 in the CG and 28 in the IG.
Results: There was no significant difference (p < 0.05) in sample characteristics, clinical and perioperative data between groups. There was a significant increase (p < 0.05) in RR and MAP after the intervention in CG and IG. Only in GI there was a significant reduction in the respiratory distress score (p = 0.001). Furthermore, there was a lower score (p < 0.0001) on the scale of pulmonary complications at the end of the interventions in the IG group, compared to the CG.
Discussion: The TAR method reduced respiratory distress and pulmonary complications in patients after CABG surgery. Given our findings, it becomes feasible to aim for the applicability of the method in other populations, expanding it to other elective or non-elective surgical conditions, in oncology, traumatology, and neurology, making the recovery process more effective.
期刊介绍:
Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.