Post Coronary Artery Bypass GraftingPost-Cardiac Surgery PatientsUpper Cross SyndromeRespiratory Muscle WeaknessRespiratory Muscle Training
Investigational drug(s) / intervention(s)
Respiratory Muscle Training by (The Breather)Traditional physical therapy program
Respiratory Muscle Training by (The Breather): Patients are instructed to inhale deeply and forcefully (at non fatigable resistance) for 2-3 seconds, slight pause, and then exhale forcefully for 2-3 seconds for 10 repetitions with 2 sets.
Traditional physical therapy program: Traditional physical therapy program in form of: (TENS / Low-intensity continuous ultrasonic / Infrared radiation application / Cervical Stabilization exercise )
Study summary
The purpose of this study is to investigate if there is any effect of the respiratory training on cardiopulmonary functions in patients with upper cross syndrome post-cardiac surgery.
Hypothesis:
Null hypothesis: There is no effect of the respiratory training on pulmonary functions in patients with upper cross syndrome post-cardiac surgery.
Eligibility
Sex
MALE
Min age
45 Years
Max age
55 Years
Healthy volunteers
No
Inclusion Criteria:
* Sixty post-CABG-male-patients for at least three months and their age ranges from 45 to 55 years old.
* Craniovertebral angle \< 51°, but not less than 30°.
* Non-specific chronic neck pain: defined as neck pain without an identifiable pathological cause and attributed to poor posture without radiation to upper limbs.
* VAS score between 3-7.
* Their body mass index ranges from (25 -29.9) kg/m2.
* Values of FEV1 and FVC lower than 80%
Exclusion Criteria:
* Rheumatoid arthritis, cervical disc pathology, and traumatic neck pain.
* History of respiratory disease and clinical signs of severe cardiac events.
* Neurological disorders which affect the diaphragm.
* Patients whose BMI is less than 25, or greater than 30 kg/m2.
* Smokers.
* Values of FEV1 and FVC higher than 80%
* Patients with chronic obstructive pulmonary disease or asthma.
Primary outcome measure(s)
Pulmonary functions: — Baseline (assessment), and at 12 weeks post-intervention. Measurements of ventilatory function are recorded before and after receiving the treatment sessions (FEV1, FVC, FEV1/FVC, MVV).
Assessing respiratory improvement.
Unit of Measure: Liters (L)
Six-Minute-Walk Test — Baseline (assessment), and at 12 weeks post-intervention. Patients are asked to walk for 6 minutes along a flat corridor. Measured in meters, assessing exercise capacity and functional improvement.
The SpO2 and heart rate are measured continuously during testing.
Heart Rate (HR): Measured in beats per minute (BPM), evaluating cardiovascular response.
SpO2 (Peripheral Oxygen Saturation): Assessing: Blood oxygen saturation levels to evaluate respiratory and cardiovascular efficiency. Unit of Measure: Percentage (%)
VO2 max (Maximal Oxygen Consumption) — Baseline (assessment), and at 12 weeks post-intervention. Assessing: Maximum oxygen uptake during high-intensity exercise to evaluate aerobic capacity and cardiopulmonary function.
Estimated based on an equation which contains:
weight is body weight (kg), 6MWD is distance walked in 6 min (m), age (years), BMI is calculated body mass index(kg/m2), height is body height (cm) and HR is heart rate at the end of the walking test.
Unit of Measure: mL/kg/min
Pittsburgh Sleep Quality Index. — Baseline (assessment), and at 12 weeks post-intervention. Respondents are asked to indicate how frequently they have experienced certain sleep difficulties and rate them. Scores for each question range from 0 to 3, with higher scores indicating more acute sleep disturbances.
Short Form 36 (SF-36) Health Survey Questionnaire (Arabic version). — Baseline (assessment), and at 12 weeks post-intervention. A 36-item scale measures eight domains of health status. The scores are transformed to range from zero where the respondent has the worst possible health to 100 where the respondent is in the best possible health.
Pain severity — Baseline (assessment), and at 12 weeks post-intervention. Assessing intensity of perceived pain for monitoring changes in pain severity throughout the intervention. Pain severity is assessed by the self-reported Visual Analog Scale (VAS). By using a 10 cm line where patients mark their pain level, with 0 representing "no pain" and 10 representing "worst imaginable pain." Unit of Measure: Points on a 0-10 scale
Endurance of DCF — Baseline (assessment), and at 12 weeks post-intervention. Endurance of DCF muscles is measured by a pressure biofeedback instrument. The patient lays in the crook lying position and the pressure biofeedback instrument is placed under the neutral cervical spine below the occiput and inflated up to 20 mmHg. The subjects perform this movement at 5 different pressure levels, i.e., 22, 24, 26, 28, and 30 mmHg. Each level is supposed to be held for 10 sec, and the test terminated if they are unable to hold the position for 10 sec at any level or if the maximum level is achieved (30 mmHg).
Craniovertebral angle measurement — Baseline (assessment), and at 12 weeks post-intervention. Adhesive markers are placed on the tragus of the right ear and the C7 spinous process, and the subjects are instructed to stand by side (lateral view) and to look at a target in front of them with both arms beside the body. Then, a digital camera is fixed at the level of the 7th cervical vertebra. Finally, the Surgi map Spine software is used to analyze the digitalized photographs and measure CVA. It is the angle between 2 imaginary lines: the horizontal line passing through the spinous process of C7 and the line passing from C7 to the tragus of the ear.
Weight and height measurement — Baseline (assessment) Weight and height are recorded, and BMI will be calculated according to the formula: BMI = Weight (Kg) / Height (m2)
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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