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Post-Operative Outcomes of Pre-Thoracic Surgery Respiratory Muscle Training vs Aerobic Exercise Training: A
Rajesh Kunadharaju1, Arjun Saradna1, Andrew Ray2
1University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Department of Pulmonary, Critical Care, and Sleep Medicine, Buffalo, NY.
Archives of Physical Medicine and Rehabilitation
|December 20, 2022
Summary
Preoperative respiratory muscle training (RMT) and aerobic exercise training (AET) are comparable in preventing postoperative pulmonary complications and reducing hospital stays for thoracic surgery patients. Both methods offer significant benefits, making them valuable interventions.
Area of Science:
- Thoracic Surgery Outcomes
- Pulmonary Rehabilitation
- Evidence-Based Medicine
Background:
- Thoracic surgeries pose significant risks for postoperative pulmonary complications (PPC).
- Preoperative exercise interventions aim to mitigate these risks and improve patient recovery.
- Comparing the efficacy of different preoperative training modalities is crucial for optimizing patient care.
Approach:
- A comprehensive meta-analysis was conducted, searching PubMed, EMBASE, Cochrane, and Web of Science.
- Included randomized control studies comparing preoperative respiratory muscle training (RMT) and aerobic exercise training (AET) against a control group.
- Network meta-analysis using Bayesian random-effects models assessed outcomes like PPC, pneumonia, respiratory failure, and hospital length of stay.
Key Points:
- Both RMT and AET significantly reduced PPC, pneumonia, and postoperative respiratory failure (PRF).
- Hospital length of stay (HLOS) was reduced by approximately 1.7 days with both RMT and AET.
- No significant differences were found in mortality or PRF between RMT and AET compared to usual care, with RMT and AET ranking similarly in effectiveness.
Conclusions:
- Preoperative RMT is comparable to AET in preventing PPC, pneumonia, and PRF, and in reducing HLOS following thoracic surgery.
- Both interventions are effective and can be considered for patients undergoing thoracic procedures.
- RMT may be a viable option in resource-limited settings due to its comparable efficacy.
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