Effects of inspiratory muscle training on postoperative cardiopulmonary function and quality of life after oesophagectomy

Abstract

Objective To investigate the effect of preoperative and postoperative inspiratory muscle training(IMT) on cardiopulmonary function and quality of life for patients undergoing esophagectomy. Methods Sixty patients who had received esophagectomy for esophageal cancer were randomly divided into an observation group (n=30) and a control group (n=30). All of the subjects were given conventional treatment (including preoperative health education, abdominal respiration training, pursed lip respiration training and expectoration training). On this basis, the patients in the treatment group were advised to do deep respiratory training using a breathing training device, four times a day, lasting 20 minutes each time, for 10 days (including five days before and five days after the operation). Respiratory muscle strength, blood gases, six minute walk test (6MWT) distances and Borg dyspnea scores were measured on admission, on the day prior to the operation and on the 1st, 3rd and 5th day after the operation. And also on admission and on the 5th day after the operation their pulmonary function was tested, and their psychological status and quality of life were evaluated using the hospital anxiety and depression scale (HADS) and the Nottingham health profile (NHP) respectively. Results There was no significant difference in any index between the two groups on admission(P>0.05). Everyone's respiratory function and exercise capacity were sharply decreased, and Borg dyspnea score increased on the first postoperative day, and then gradually and significantly improved in both groups compared to that on admission(P<0.05). On the fifth postoperative day, the maximal inspiratory pressure of 67.41±14.53 mmH2O, maximal ventilatory volume of 79.83±5.37 L, 6MWT of 427.19±46.52 m, Borg score of 1.45±0.48 points, postoperative anxiety score of 8.14±2.80 points, NHP total (128.91±25.12 points), NHP pain score (24.66±10.12 points), NHP sleeping score (25.18±9.75 points), and NHP physical activity scores (22.81±10.72 points) were significantly more improved in the observation group than those in the control group(P<0.05). Conclusion Preoperative and postoperative inspiratory muscle training can significantly reduce postoperative anxiety symptoms, improve postoperative cardiopulmonary function and the quality of life during perioperative period. Such therapy deserves further clinical research. Key words: Esophageal carcinoma; Inspiratory muscle training; Pulmonary function; Quality of life; Anxiety