Obesity
Conditions
Keywords
obesity, gastroplasty, respiratory muscle training, muscle strength, physical therapy
Brief summary
The purpose of this study is to assess the effect of post-operative inspiratory muscle training on muscle strength and endurance in patients with obesity submitted to gastroplasty.
Detailed description
Gastroplasties, like other major abdominal surgeries, induce mechanical changes in the lungs and decreases of the respiratory muscle strength in the post-operative periods. Depending on the occurrence of pre-existing disturbs, obese patients may exhibit severe declines of respiratory function after these surgeries. Post-operative respiratory physiotherapy is a valuable intervention, involving a set of techniques aimed to expand pulmonary volumes and to improve arterial oxygenation, leading to decreases on the development of atelectasis and pneumonias. It induces faster recovery of respiratory function and reduction of lung complications, what may be particularly important in high-risk patients like over-weighted subjects. There are scanty data about the role of respiratory muscle training in the post-operative period. This is particularly true regarding inspiratory muscle training of obese patients submitted to gastroplasties.
Interventions
DEVICEinspiratory muscle training
This daily respiratory exercise was performed from the 2nd day following surgery by using a linear pressure resistance device (Threshold ® IMT - Health Scan Products; USA)was initially set at 40% of the maximal inspiratory pressure, obtained in the 2nd post-operative day, being adjusted to every new maximal inspiratory pressure measurement.
DEVICEcontrol group
In placebo muscular training the daily respiratory exercise was performed from the 2nd day following surgery by using a linear pressure resistance device (Threshold ® IMT - Health Scan Products; USA)no load until the 30th post-operative day.
Sponsors
University of Sao Paulo
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
20 Years to 58 Years
Healthy volunteers
No
Inclusion criteria
* gastroplasty patients presenting body mass index (BMI) ≥ 35 kg/m2; * weighting ≤ 60 kg/m2; * capable of fulfilling the experimental protocol.
Exclusion criteria
* acute or chronic pulmonary disease; * smoking; * post-operative mechanical ventilation for more than 48 hours; * presence of lung complications; * need for surgical re-intervention during the study period.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maximum static respiratory pressures | post-operative days 2, 7, 14, and 30 | This measurement was made at mouth level by using a properly calibrated manovacuometer (GERAR ®, São Paulo, Brazil), with graduation ranging from 0 to ± 300 cmH2O, connected to a rigid plastic tube. |
| Inspiratory muscular endurance test | post-operative days 2, 7, 14, and 30. | This measurement was performed by using the Threshold® IMT device (Health Scan Products, USA), at 80% maximal inspiratory pressure, in sitting position. |
| Spirometric measurements | post-operative days 2, 7, 14, and 30. | Spirometry was performed according to norms of the American Thoracic Society (ATS) (1994)19 by using a previously calibrated spirometer (Respiradyne II Plus®, Sherwood Medical, St. Louis, USA). |
Secondary
| Measure | Time frame |
|---|---|
| Maximum static respiratory pressures | post-operative days 2, 7, 14, and 30 |
| Inspiratory muscular endurance test | post-operative days 2, 7, 14, and 30 |
| Spirometric measurements | post-operative days 2, 7, 14, and 30. |
Countries
Brazil
Outcome results
None listed