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.
Objective: To assess the impact of IMT on the functional capacity of patients undergoing CABG with a high risk of PPC. Design: This is a randomized clinical trial. Setting: Instituto Nobre de Cardiologia (INCARDIO), Feira de Santana – Bahia. Subjects: In total, 29 patients were selected at high risk of pulmonary complications. Intervention: Patients were divided into two groups at risk of CPP: intervention group (IM) submitted to IMT and control group (CG) who received standard care. Considered a high risk patient, age over 60 years, diabetic, smoker and body mass index above 27 kg / m2. All were submitted to preoperative evaluation and hospital discharge for maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and six-minute walk test (6MWT). Results: 29 individuals were evaluated, 19 of whom were female (65%) and the mean age was 67±4 years. The IG showed MIP before of 103±15 and the CG 105±17cmH2O (p=0.35), at discharge the IG had 80±14 and the CG 75±15cmH2O (p=0.12). The 6MWT in the pre was 386±43 in the IG and 398±56 meters (p = 0.65). In the CG, at discharge they covered 285±51 meters in the IG and 288±45 in the CG (p=0.34). There were no differences between the variables of the groups. Conclusion: It is concluded that the IMT performed in the postoperative period did not show significance on the variables muscle strength and functional capacity in patients who were at high risk of pulmonary complications.