Efeito dos treinamentos musculares respiratório e periférico na capacidade funcional de indivíduos submetidos à cirurgia de revascularização do miocárdio

Abstract

Pulmonary and peripheral dysfunctions following coronary artery bypass grafting (CABG) surgery include complications in pulmonary function (PF) and the loss of respiratory (RMS) and peripheral muscle strength (PMS). The effect of respiratory muscle training (RMT) and muscle peripheral training (MPT) on the functional capacity (FC) in patients with CABG surgery is unknown. The objective of this study was to investigate the influence of RMT and MPT on an early recovery from CF and quality of life in patients with CABG surgery. A randomized controlled clinical trial was conducted with 83 adult volunteers of both sexes divided into two groups: control (CG), with 42 individuals, and intervention (IG), with 41 individuals. Participants underwent RMT and MPT sessions after the CABG surgery until the 5th postoperative day (PO5). The intensity of RMT, characterized by inspiratory muscle training (IMT) and expiratory muscle training (EMT), was calculated by the means of 15% of the values obtained by manovacuometry. The control group performed conventional physiotherapy. In addition to conventional physiotherapy, the IG performed IMT, EMT and MPT. The PF was evaluated by a portable device called the Peak Flow Meter (ASSESS®); the CF by means of the 6-minute walk test (6MWT); the quality of life by the generic instrument MOS SF-36; and the peripheral muscle force (PMS) by the JAMAR dynamometer. The results of this study showed that IG had lower inspiratory muscle strength loss (p < 0.05) than CG, and there was no significant difference in relation to PMF (p > 0.05). In addition, the findings did not demonstrate the influence of such gain on the FC (p > 0.05). Regarding the quality of life, IG individuals presented greater sensation of vitality (p < 0.05) and also greater pain perception (p < 0.05) in relation to CG. It was possible to conclude that IMT promotes a lower loss of RMS in patientes with CABG surgery and that the association between PMT and RMT in these individuals improves the perception of vitality and increases the perception of pain. Although this association did not show significant improvement in relation to FC, we suggest that new studies, with a larger sample, can be developed in order to obtain more evidence.