ABSTRACT
BACKGROUND: Aerobic exercise and CPAP benefit patients in the postoperative period of cardiac surgery. To our knowledge, the association of aerobic exercise on an exercise bicycle with CPAP has not yet been demonstrated. Therefore, we aimed to evaluate the effectiveness of physical exercise on a cycle ergometer combined with CPAP in the postoperative period after coronary artery bypass graft surgery. METHODS: This was a randomized clinical trial, with recruitment from May 2017 to December 2017 (registered in the Brazilian Clinical Trials Registry: RBR-69CDYF). The step group (n = 16 subjects) started rehabilitation in the immediate postoperative period with breathing exercises and passive mobilization in the sitting position, progressing to active exercises, ambulation, and stair training. For the intervention group (n = 15 subjects), dynamic exercises on a cycle ergometer combined with CPAP were added to the step program from the second to the fourth postoperative day in a single daily session. RESULTS: Functional capacity decreased in both groups, but this reduction was not significant in the intervention group (P = .11). The length of stay in ICU was lower in the intervention group (P = .050). In both groups there was a decrease in maximum inspiratory and expiratory pressure, as well as in the 1-min sit-to-stand test on the fourth postoperative day compared to the preoperative period. CONCLUSIONS: Physical exercise combined with CPAP promoted the maintenance of functional capacity and reduced the length of stay in the ICU.
Subject(s)
Cardiac Rehabilitation/methods , Continuous Positive Airway Pressure , Coronary Artery Bypass/rehabilitation , Exercise , Adult , Aged , Brazil , Breathing Exercises , Exercise Therapy , Female , Humans , Intensive Care Units , Length of Stay , Male , Middle Aged , Muscle Strength , Myocardial Revascularization/rehabilitation , Postoperative Period , Quality of Life , Time Factors , WalkingABSTRACT
Objetivo: avaliar a correlação da dor e independência funcional no período pré e pós-operatório dos pacientes submetidos à cirurgia cardíaca. Métodos: estudo prospectivo e não intervencionista composto por 24 pacientes que realizaram cirurgia cardíaca eletiva. Foram coletados os dados clínicos nos prontuários dos pacientes e realizada entrevista direta no pré-operatório e no pós-operatório. A intensidade de dor foi avaliada pela Escala Visual Numérica e a funcionalidade pela Medida de Independência Funcional. Resultados: na primeira avaliação, os pacientes não relataram dor. Na avaliação pós-operatória, os pacientes apresentaram uma média de 4,75 ± 1,91 pontos na escala de dor. A funcionalidade passou de 124,29 ± 6,38 no pré-operatório para 97,42 ± 12,73 no pós-operatório. Verificou-se correlação significativa entre dor e funcionalidade. Conclusão: ocorreu aumento da dor e redução da funcionalidade no pós-operatório de cirurgia cardíaca, além de correlação entre as variáveis, demonstrando que quanto maior a intensidade da dor, menor é a independência funcional do paciente.
Objetivo: evaluar la correlación del dolor e independencia funcional en el período pre y postoperatorio de los pacientes sometidos a la cirugía cardiaca. Métodos: estudio prospectivo y no intervencionista compuesto por 24 pacientes que realizaron cirugía cardíaca electiva. Se recogieron los datos clínicos en los prontuarios de los pacientes y se realizó una entrevista directa en el preoperatorio y en el postoperatorio. La intensidad de dolor fue evaluada por la Escala Visual Numérica y la funcionalidad por la Medida de Independencia Funcional. Resultados: en la primera evaluación, los pacientes no reportaron dolor. En la evaluación postoperatoria, los pacientes presentaron una media de 4,75 ± 1,91 puntos en la escala de dolor. La funcionalidad pasó de 124,29 ± 6,38 en el preoperatorio a 97,42 ± 12,73 en el postoperatorio. Se verificó una correlación significativa entre el dolor y la funcionalidad. Conclusión: ocurrió aumento del dolor y reducción de la funcionalidad en el postoperatorio de cirugía cardíaca, además de correlación entre las variables, demostrando que cuanto mayor es la intensidad del dolor, menor es la independencia funcional del paciente.
Objective: to evaluate the correlation of pain and functional independence in the pre and postoperative period of patients submitted to cardiac surgery. Methods: A prospective, noninterventional study of 24 patients submitted to elective cardiac surgery. Clinical data was collected in patients' charts and a direct interview was done both in the preoperative and in the postoperative period. The pain intensity was rated according to the Numerical Visual Scale. Functionality was measured with the Functional Independence Measure. Results: in the first evaluation, the patients did not report pain. In the postoperative evaluation, patients presented an average of 4.75 ± 1.91 points on the pain scale. The functionality increased from 124.29 ± 6.38 in the preoperative period to 97.42 ± 12.73 in the postoperative. There was a significant correlation between pain and functionality. Conclusion: there was an increase in pain and reduced functionality in the postoperative period of cardiac surgery, in addition to a correlation between the variables, demonstrating that the higher the intensity of the pain, the lower the functional independence of the patient.
