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Inspiratory muscle training for diaphragm dysfunction after cardiac surgery
Metka Kodric1, Roberto Trevisan, Chiara Torregiani
1Department of Pneumology, University Hospital of Cattinara, Trieste, Italy.
The Journal of Thoracic and Cardiovascular Surgery
|September 4, 2012
Summary
Early inspiratory muscle training can improve diaphragm mobility and strength in patients with diaphragm paralysis after cardiac surgery. This non-surgical approach offers a potential benefit for recovery.
Area of Science:
- Cardiology
- Pulmonology
- Neurosurgery
Background:
- Diaphragm dysfunction is a common complication following cardiac surgery, often with limited spontaneous recovery.
- Surgical diaphragm plication is the primary intervention for persistent symptoms, but carries surgical risks.
- Nerve lesion recovery can be enhanced through targeted training, suggesting a potential role for muscle training in diaphragm dysfunction.
Purpose of the Study:
- To investigate the efficacy of early diaphragm muscle training in patients with post-cardiac surgery diaphragm paralysis.
- To compare the recovery of diaphragm function in patients undergoing inspiratory muscle training versus a control group receiving sham training.
Main Methods:
- A prospective, randomized controlled trial involving 69 adult patients with diaphragm paralysis post-cardiac surgery.
- Patients were randomized 2:1 to receive diaphragm training with an adjustable pressure device or a sham device for 1 year.
- Outcomes included diaphragm mobility (sniff fluoroscopy), maximal respiratory pressures, and lung function tests.
Main Results:
- Inspiratory muscle training significantly improved diaphragm mobility after 12 months (P < .001).
- A majority of patients in the training group (77.78%) showed partial or complete improvement in diaphragm mobility.
- In contrast, 87.5% of the control group showed no improvement, with only 12.5% experiencing partial recovery.
Conclusions:
- Early inspiratory muscle training can enhance inspiratory muscle strength.
- Diaphragm training may increase the mobility of a paralyzed diaphragm, offering a non-invasive therapeutic option.
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