Upper Extremity Exercises With and Without Deep Breathing After Cardiac Surgery

Официальное название

Evaluation of the Effects of Upper Extremity Range of Motion Exercises Performed With and Without Deep Breathing on Respiratory Parameters After Cardiac Surgery: A Randomized Trials

Обзор

This randomized 2×2 crossover trial aims to evaluate the effects of upper extremity range of motion exercises performed with and without deep breathing on respiratory parameters in patients after open cardiac surgery. The study will include adult patients who underwent elective open cardiac surgery and are receiving postoperative care in the cardiovascular surgery intensive care unit. Each participant will perform both exercise protocols: upper extremity range of motion exercises alone and upper extremity range of motion exercises combined with deep breathing. The order of the two interventions will be randomized. Respiratory and clinical outcomes, including oxygen saturation, tidal volume, respiratory rate, heart rate, pain, perceived exertion, and dyspnea, will be assessed before and after each intervention.

Подробное описание

Postoperative pulmonary complications are common after cardiac surgery and may include atelectasis, pulmonary edema, hypoxemia, reduced lung volumes, impaired thoracic mobility, and respiratory muscle dysfunction. Median sternotomy, postoperative pain, fear of movement, prolonged immobilization, and changes in respiratory mechanics may contribute to impaired pulmonary function during the early postoperative period.

Postoperative physiotherapy, early mobilization, breathing exercises, and range of motion exercises are commonly included in standard postoperative care after cardiac surgery. Deep breathing exercises are recommended to support lung expansion and improve pulmonary function, while upper extremity range of motion exercises may contribute to thoracic mobility, postural drainage, secretion clearance, and functional recovery. However, evidence regarding the immediate effects of standardized upper extremity exercises on respiratory parameters after open cardiac surgery remains limited.

Previous studies have examined respiratory physiotherapy, mobilization, and exercise-based interventions after cardiac surgery, and some evidence suggests potential benefits on lung function and inspiratory capacity. Nevertheless, the specific contribution of upper extremity range of motion exercises performed with versus without deep breathing has not been sufficiently clarified. This study is designed to compare the immediate effects of these two standardized exercise protocols on oxygen saturation, tidal volume, respiratory rate, heart rate, pain, perceived exertion, and dyspnea in patients after cardiac surgery.

Вмешательства

• Поведенческое Deep Breathing Exercise
  Participants will perform slow and deep breathing exercises in a sitting position. Measurements will be recorded before and immediately after the intervention.
• Поведенческое Upper Extremity ROM Exercise Combined with Deep Breathing
  Participants will perform bilateral upper extremity range of motion exercises while taking a slow deep breath during arm elevation and exhaling during arm lowering. The exercise will be repeated five times in a sitting position. Measurements will be recorded before and immediately after the intervention.

Первичные конечные точки

• Change in Oxygen Saturation SpO₂ [Срок оценки: Baseline and immediately after each intervention.]

Вторичные конечные точки (3)

• Change in Respiratory Rate [Срок оценки: Baseline and immediately after each intervention.]
• Change in Heart Rate [Срок оценки: Baseline and immediately after each intervention.]
• Change in Pain Intensity Assessed by the Numeric Rating Scale [Срок оценки: Baseline and immediately after each intervention.]

Критерии участия

Критерии включения

• underwent elective open-heart surgery,
• stayed in the cardiovascular ICU for at least 2 nights post-operatively,
• had FiO2 below 40% (Spo2 will be kept above 92),
• were conscious,
• could speak Turkish,
• were willing to participate in the study.

Критерии исключения

underwent another thoracic surgery or repeat surgery simultaneously,

• had any limb loss,
• underwent prolonged immobilization and intubation,
• developed serious complications such as infection or respiratory failure after surgery,
• had problems such as paresthesia, plegia, etc. after stroke, or had diseases such as Parkinson's that affect the level of relaxa

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Распределение

Рандомизированное

Модель

Перекрёстный дизайн

Маскирование

Открытое

Основная цель

Другое

Центры проведения

Turkey (Türkiye) · 1 центр

• Kocaeli University — İzmit

Публикации

• Amin R, Alaparthi GK, Samuel SR, Bairapareddy KC, Raghavan H, Vaishali K. Effects of three pulmonary ventilation regimes in patients undergoing coronary artery bypass graft surgery: a randomized clinical trial. Sci Rep. 2021 Mar 24;11(1):6730. doi: 10.1038/s41598-021-86281-4. PMID 33762655

Идентификаторы

NCT: NCT07627009 · KOU-CVS-ROM-DB-2026

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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