The effectiveness of perioperative respiratory muscle exercise in elderly cardiac surgery patients: a randomized controlled trial.

Wang, Qiaoying; Shao, Jiayi; Peng, Yanchun; Li, Sailan; Chen, Liangwan; Lin, Yanjuan · Arch Phys Med Rehabil · 2026

rct · Level II

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Abstract

This study aimed to evaluate the impact of perioperative respiratory muscle training on respiratory muscle strength, pulmonary function, functional capacity and prognostic outcomes in patients undergoing surgery. A randomized controlled trial. Cardiac surgery ward and cardiac surgery intensive care unit of a tertiary Grade A hospital in Fuzhou, China. Eighty-two participants. Perioperative respiratory muscle exercise. Eighty-two patients were randomly assigned to either the intervention group (n = 42), who performed perioperative respiratory muscle training, or the control group (n = 40). Patients completed one session per day from admission to discharge (except during mechanical ventilation). Respiratory muscle strength was assessed upon admission, the day before surgery, on the third day post-intensive care unit transfer, and at discharge. Each patient underwent a lung function test, six-minute walk test, self-efficacy for exercise scale, anxiety and depression test, and quality of life questionnaire, before and after intervention. The intervention group showed significantly greater improvements in maximal inspiratory pressure (57.69 ± 10.85 cmH<sub>2</sub>O vs. 48.28 ± 10.30 cmH<sub>2</sub>O), pulmonary function, functional capacity, postoperative pulmonary complications (38.1% vs. 65.0%), inspiratory muscle weakness (42.9% vs. 85.0%), duration of mechanical ventilation and intensive care unit stay, level of anxiety and depression, quality of life, and length of post-operative hospitalization. Additionally, the incidence of postoperative pulmonary (9.5% vs. 22.5%) and re-hospitalization within six months (9.5% vs. 17.5%) was reduced, though not statistically significant. Perioperative respiratory muscle training could contribute to improved respiratory muscle strength, pulmonary function, functional capacity, prognostic outcome, and quality of life in elderly cardiac surgery patients. Continuous activation of the respiratory muscles could provide multiple benefits for these individuals.