Acute Effect of the Thoraco-abdominal Rebalance Method Postoperative Cardiac Surgery

Condition(s) studied

Investigational drug(s) / intervention(s)

TAR Method: Patients selected for the intervention group will undergo thoracoabdominal rebalancing management such as abdominal supports and/or in the ileocostal space, inspiratory assistance, release of the shoulder girdle, thoracic balance, release of the pectoralis major and deltoid muscles together with aspiration if necessary.

Conventional physiotherapy: Patients selected for the control group (conventional physiotherapy) will be exposed to respiratory physiotherapy techniques such as vibrocompression, manual passive expiratory therapy, acceleration of expiratory flow, fractional inspiration in times, diaphragmatic breaths and aspiration when necessary.

Study summary

Introduction: The thoracoabdominal rebalancing (TAR) method aims to promote diaphragmatic juxtaposition, in addition to seeking to increase respiratory muscle strength and adjust muscle tone. However, scientific publications on this method in heart patients undergoing coronary artery bypass grafting (CABG) are still scarce, justifying the need to carry out this study for information, evaluation, diagnosis and treatment purposes in the health area with an emphasis on cardiology.

Objective: To evaluate whether diaphragmatic ultrasound findings differ between the TAR method and conventional physiotherapy in post-CABG patients.

Methods: This is a randomized, single-blind clinical trial. Adults (\>35 years), hemodynamically stable, who underwent CABG (\<24 hours) and had a prescription for physiotherapy will be included. Patients will be randomized into two groups: 1) intervention group \[IG\] - TAR; 2) control group \[CG\] - standard physiotherapy approach. Interventions will be performed at a single time and the following variables will be collected pre- and post-intervention: heart rate (HR), respiratory rate (RR), peripheral oxygen saturation (SpO2), mean arterial pressure (MAP), diaphragmatic ultrasound (US) to identify possible acute findings in both groups, respiratory distress scale and pulmonary complications scale will be applied at the end of the interventions.

Keywords: Physiotherapy; Cardiology; Ultrasonography

Eligibility

Primary outcome measure(s)

• Diaphragmatic excursion — Immediately before the intervention and within 30 minutes after the intervention
  Increase in measures
• Change in the Downes and Raphaelly respiratory distress scale — Immediately before the intervention and within 30 minutes after the intervention
  Points 0-10, where 0 is best and 10 is worst
• Pulmonary spirometry — Immediately before the intervention and within 30 minutes after the intervention
  Increase in measurements: CVF (L)

Trial sites (1)

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