Cardiac Surgery
Conditions
Keywords
Cardiac surgery, Range of motion exercise, Deep breathing exercise, Postoperative respiratory function
Brief summary
This randomized 2×2 crossover trial aims to evaluate the effects of upper extremity range of motion exercises performed with and without deep breathing on respiratory parameters in patients after open cardiac surgery. The study will include adult patients who underwent elective open cardiac surgery and are receiving postoperative care in the cardiovascular surgery intensive care unit. Each participant will perform both exercise protocols: upper extremity range of motion exercises alone and upper extremity range of motion exercises combined with deep breathing. The order of the two interventions will be randomized. Respiratory and clinical outcomes, including oxygen saturation, tidal volume, respiratory rate, heart rate, pain, perceived exertion, and dyspnea, will be assessed before and after each intervention.
Detailed description
Postoperative pulmonary complications are common after cardiac surgery and may include atelectasis, pulmonary edema, hypoxemia, reduced lung volumes, impaired thoracic mobility, and respiratory muscle dysfunction. Median sternotomy, postoperative pain, fear of movement, prolonged immobilization, and changes in respiratory mechanics may contribute to impaired pulmonary function during the early postoperative period. Postoperative physiotherapy, early mobilization, breathing exercises, and range of motion exercises are commonly included in standard postoperative care after cardiac surgery. Deep breathing exercises are recommended to support lung expansion and improve pulmonary function, while upper extremity range of motion exercises may contribute to thoracic mobility, postural drainage, secretion clearance, and functional recovery. However, evidence regarding the immediate effects of standardized upper extremity exercises on respiratory parameters after open cardiac surgery remains limited. Previous studies have examined respiratory physiotherapy, mobilization, and exercise-based interventions after cardiac surgery, and some evidence suggests potential benefits on lung function and inspiratory capacity. Nevertheless, the specific contribution of upper extremity range of motion exercises performed with versus without deep breathing has not been sufficiently clarified. This study is designed to compare the immediate effects of these two standardized exercise protocols on oxygen saturation, tidal volume, respiratory rate, heart rate, pain, perceived exertion, and dyspnea in patients after cardiac surgery.
Interventions
BEHAVIORALDeep Breathing Exercise
Participants will perform slow and deep breathing exercises in a sitting position. Measurements will be recorded before and immediately after the intervention.
BEHAVIORALUpper Extremity ROM Exercise Combined with Deep Breathing
Participants will perform bilateral upper extremity range of motion exercises while taking a slow deep breath during arm elevation and exhaling during arm lowering. The exercise will be repeated five times in a sitting position. Measurements will be recorded before and immediately after the intervention.
Sponsors
Kocaeli University
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
OTHER
Masking
NONE
Masking description
Due to the nature of the exercise interventions, blinding of participants and intervention providers will not be feasible. Outcome measurements will be obtained using standard clinical monitoring devices and patient-reported scales.
Intervention model description
Participants will be randomized to one of two sequences. Each participant will receive both upper extremity exercise protocols, with and without deep breathing, in a 2×2 crossover design.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* underwent elective open-heart surgery, * stayed in the cardiovascular ICU for at least 2 nights post-operatively, * had FiO2 below 40% (Spo2 will be kept above 92), * were conscious, * could speak Turkish, * were willing to participate in the study.
Exclusion criteria
underwent another thoracic surgery or repeat surgery simultaneously, * had any limb loss, * underwent prolonged immobilization and intubation, * developed serious complications such as infection or respiratory failure after surgery, * had problems such as paresthesia, plegia, etc. after stroke, or had diseases such as Parkinson's that affect the level of relaxa
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Oxygen Saturation SpO₂ | Baseline and immediately after each intervention. | Oxygen saturation will be measured using a bedside clinical monitor or pulse oximeter. SpO₂ represents the percentage of hemoglobin saturated with oxygen in the blood and will be recorded as a percentage. Higher values indicate better oxygenation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Respiratory Rate | Baseline and immediately after each intervention. | Respiratory rate will be assessed as the number of breaths taken per minute and recorded as breaths per minute |
| Change in Heart Rate | Baseline and immediately after each intervention. | Heart rate will be measured using a bedside clinical monitor and recorded as beats per minute. |
| Change in Pain Intensity Assessed by the Numeric Rating Scale | Baseline and immediately after each intervention. | Pain intensity will be assessed using the Numeric Rating Scale, ranging from 0 to 10. Higher scores indicate greater pain intensity. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORMUSTAFA CANİKOĞLU, Assist. Prof
Kocaeli University
STUDY_CHAIRYasemin Özhanlı, Assist. Prof
Kocaeli University
Outcome results
None listed