Efeitos do exercício aeróbico na fase I da reabilitação cardíaca de pacientes submetidos à revascularização do miocárdio: ensaio clínico controlado randomizado

• Autor(a) principal: Borges, Daniel Lago
• Data de Publicação: 2017
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/8605
• topic: Cardiac surgery; Coronary artery bypass grafting; Aerobic exercise; Rehabilitation; Cirurgia cardíaca; Revascularização miocárdica; Exercício aeróbico; Reabilitação; Coração Cirurgia; Cirurgia torácica; Revascularização do miocárdio; Exercícios aeróbicos; Reabilitação cardíaca; CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL

Physical activity is beneficial for patients undergoing cardiac surgery. However, few researches demonstrated the effects of early aerobic exercises after cardiac surgery, during hospital stay. To investigate the effects of early cycle ergometer exercises in patients underwent coronary artery bypass grafting (CABG). It s is a randomized controlled clinical trial which includes patients underwent CABG allocated in two groups: control group, submitted to conventional physiotherapy and intervention group, which received the same protocol plus additional aerobic exercise with cycle ergometer since first postoperative day. Pulmonary function, respiratory muscle strength, functional capacity was assessed before surgery and at hospital discharge. During aerobic exercise, heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP), double product (DP), peripheral oxygen saturation (SpO2) and respiratory rate (RR) were assessed before, in the third and fifth minutes, and after each session. Clinical complications and electrocardiographic alterations were also verified. There was significant reduction in pulmonary function and inspiratory muscle strength was maintained while expiratory muscle strength significantly decreased in both groups. Functional capacity was maintained in the intervention group (364.5 [324.5 to 428] vs. 348 [300.7 to 413.7] meters, p = .06), but it decreased significantly in control group patients (320 [288.5 to 393.0] vs. 292 [237.0 to 336.0] meters, p = .01). A significant difference in functional capacity was also found in intergroup analyses at hospital discharge (p = .03). Significant statistical differences were observed in all measured variables, exception in SpO2, during aerobic exercise. HR, SBP, DP and RR increased significantly during exercise, returning to baseline after intervention (p < 0.001). Statistical difference was also found between third minute and after intervention in diastolic blood pressure (p = 0.001). It is noteworthy that these differences did not result in clinical complications. Aerobic exercise applied early on coronary artery bypass grafting patients may promote maintenance of functional capacity, with no impact on pulmonary function and respiratory muscle strength when compared with conventional physiotherapy. It also promoted significant statistical cardiorespiratory changes without clinical impact, demonstrating the safety and feasibility of this intervention in the evaluated rehabilitation phase.