INSPIRATORY MUSCLE TRAINING REDUCES HEART ANXIETY IN PATIENTS SUBMITTED
TO CORONARY ARTERY BYPASS GRAFTING: CONTROLLED RANDOMIZED CLINICAL TRIAL
Abstract
Introduction:Cardiac anxiety(CA) is a common finding in patients in the
pre- and postoperative period of coronary artery bypass graft(CABG)
surgery. Ventilatory restriction generated by pain and reduced muscle
strength is associated with increased CA level. Inspiratory muscle
training(IMT) for generating increased muscle strength can cause a
decrease in CA in the postoperative period. Objective:To evaluate the
impact of IMT on inspiratory muscle strength and its relationship with
cardiac anxiety in patients undergoing CABG. Methodology:This is a
randomized controlled clinical trial. In the preoperative moment, all
patients answered a cardiac anxiety questionnaire, composed of two
domains: fear and vigilance and avoidance. In addition, their maximum
inspiratory pressure(MIP) was assessed. After the surgical procedure,
the patients were divided into a control group(CG) that received routine
hospital care and a training group(TG) who underwent an IMT protocol
until the moment of hospital discharge. Results:80 patients were
evaluated,40 in each group. The IMT group showed a 17% decrease in MIP
while the CG decreased 43%(p <0.01). The fear and vigilance
domain had a decrease of -16±3 in the CG while in the TG the reduction
was -8±3(p <0.01). The avoidance domain reduced -17±4 in the
CG vs -10±4 in the TG(p <0.01). In addition, there was a
strong correlation between the MIP of the TG with the domains of
fear/vigilance(r -0.77) and avoidance(r -0.72). Conclusion:IMT is
associated with a reduction in the loss of inspiratory muscle strength,
resulting in a reduced level of cardiac anxiety in patients undergoing
CABG.