Cardiovascular Disease, Open Heart Surgery, Physiotherapy
Conditions
Keywords
Neurophysiological facilitation technique, Cardiac rehabilitation
Brief summary
In this study, researchers aimed to investigate effects of neurophysiological facilitation on functional capacity and respiratory parameters of patients who underwent open heart surgery. Do neurophysiological facilitation techniques improve individuals' respiratory parameters more than phase 1 cardiac rehabilitation? Do neurophysiological facilitation techniques improve individuals' functional capacity more than phase 1 cardiac rehabilitation? Researchers will apply phase 1 cardiac rehabilitation to both groups to see the effectiveness of neurophysiological facilitation techniques.
Detailed description
In this study, researchers aimed to investigate effects of neurophysiological facilitation on functional capacity and respiratory parameters of patients who underwent open heart surgery. The study was performed on 32 patients who underwent open heart surgery. Patients divided into two groups which study group (n=18) and control group (n=14). Range of motion, breathing and mobilization exercises within the scope of phase 1 cardiac rehabilitation program were applied to the control group; in addition to the phase 1 cardiac rehabilitation program, neurophysiological facilitation techniques (perioral stimulation, intercostal tension, anterior basal lift, vertebral pressure, moderate manual pressure and abdominal co-contraction) were applied to the study group. Sociodemographic features and disease-specific findings were recorded on the first postoperative day . Vital signs, functional capacity, pulmonary function, fatigue and dyspnea of every patient were recorded before and after each treatment on the first four postoperative days. Functional capacity was evaluated using Timed Up and Go (TUG) test and 2-Minutes Walking test (2MWT). Pulmonary function was examined using a peak flow meter and respiratory muscle strength was measured using an intraoral pressure measurement device. In addition, fatigue and dyspnea perception was measured using Modified Borg Scale. Before the first day treatment and after the last day treatment of the four-day treatment, patients' fatigue severity were assessed with using Fatigue Severity Scale (FSS), anxiety and depression level with using Hospital Anxiety Depression Scale (HADS), fear of movement with using TAMPA Kinesiophobia Scale and life quality with using the Minnesota Heart Failure Questionnaire. Before each treatment chest circumference measurements were taken, and the perceived pain severity was recorded using Visual Analog Scale (VAS).
Interventions
PROCEDUREPhase 1 cardiac rehabilitation
Day 1:Patients were informed about the surgery, positioning and mobilization.Range of motion (ROM), respiratory control, diaphragmatic breathing, pursed lip breathing, thoracal expansion exercises, assisted coughing,forced expiration techniques, which are the components of active breathing techniques cycle (ABTC), were taught.The use of incentive spirometry (IS) was demonstrated.Patients were performed 10 repetitions of IS exercises, and 5 repetitions ABTC and were asked to repeat them every hour.The patient was made to sit for 10 minutes and was walked 60 meters twice a day. 2:ROM, IS and diaphragmatic breathing exercises were applied 10 times each.ABTC was repeated in 5 sets. 120 meters was walked 5 times during the day. 3:Sitting time was increased to 30 minutes and walking distance was increased to 240 meters.5 steps were climbed. 4:Walking distance was increased to 360 meters.One flight of stairs was climbed.Discharge training was given.
In addition to the phase 1 cardiac rehabilitation program for the group receiving neurophysiological facilitation (NPF) techniques: NPF techniques such as perioral stimulation, intercostal tension, anterior basal lift, vertebral pressure, moderate manual pressure and abdominal co-contraction were applied for ten times for ten seconds. Diaphragm facilitation exercise was performed by inhaling against resistance and holding the breath against resistance for 5 seconds. Unilateral and bilateral upper extremity proprioceptive neuromuscular facilitation (PNF) movements combined with breathing were performed. NPF techniques were performed 10 times each day throughout the treatment, while other applications (diaphragm facilitation, combined breathing exercise with upper extremity PNF technique and respiratory facilitation) were performed 5 times on the first day and 10 times on the other three days.
Sponsors
Dogus Universitesi
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Having open heart surgery for the first time, * Being between the ages of 18-75, * Being fully cooperative
Exclusion criteria
* Having facial, sternum and rib fractures, * Having chronic renal failure, * Development of cerebrovascular accident, * Having cognitive dysfunction, * Development of deep vein thrombosis in the post-operative period, * Having neuromuscular disease, * Having an orthopedic disability, * Intubation time longer than 24 hours, * Staying in intensive care for more than 48 hours
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| İnspiratory muscle strength | Before and after treatment on each day of treatment, up to 3 month | Maximum Inspiratory Pressure (MIP) - pressure |
| Expiratory muscle strength | After and before treatment on each day of treatment, up to 3 month | Maximum Expiratory Pressure (MEP) - pressure |
| 2 Minute Walk Test | Before treatment on the first day of treatment and after treatment on the last day of treatment, up to 3 month | It is walking as fast as the person can for 2 minutes without any assistance, at a safe distance of 30 meters. - meter |
| Time Up and Go (TUG) | first day of treatment before treatment and last day of treatment after treatment, up to 3 month | The person gets up from the chair, walks 3 meters, comes back and sits on the chair. - minute |
| Vital sign | Before and after treatment on each day of treatment, up to 3 month | Oxygen saturation |
| Respiratory frequency | Before and after treatment on each day, up to 3 month | Number of times a person inhales and exhales in 1 minute. - number |
| Blood pressure | Before and after treatment on day of treatment, up to 3 month | Blood pressure is the pressure of blood within the arteries of the circulatory system. - pressure |
| Heart rate | Before and after treatment on each day of treatment, up to 3 month | Number of times a person heart rate in 1 minute. - number |
| Life quality | Before treatment on the first day of treatment and after treatment on the last day of treatment, up to 3 month | The Minnesota Living with Heart Failure Questionnaire |
| Depression | Before treatment on the first day of treatment and after treatment on last day of treatment, up to 3 month | Beck's depression inventory |
| Symptom | Before and after treatment on each day of treatment, up to 3 month | Dyspnea |
Countries
Turkey (Türkiye)
Contacts
Primary ContactFeyza merakli
Backup ContactGungor
Outcome results
None listed