Abstract

Abstract Introduction: The gastroplasty post-operative period can alter respiratory mechanics and predispose patients to respiratory complications. Objective: The objective was to evaluate the effects of exercises with inspiratory load on respiratory muscle function and on the prevalence of atelectasis after gastroplasty. Method: 40 participants were randomly allocated into two groups: Control Group (CG), its members underwent conventional respiratory physical therapy (CRP) and the Inspiratory Load Group (ILG), its members performed exercises with linear inspiratory pressure load, with 40% of the maximum inspiratory pressure (MIP), associated with CRP. Therapy procedures were conducted twice during the immediate post-operative period and thrice on the first post-operative day. In addition to evaluating the MIP, the nasal inspiratory pressure (NIP) and the sustained maximum inspiratory pressure (SMIP) were evaluated before and after treatment. Analysis of variance followed by the Bonferroni correction were applied considering a 5% significance level (p < 0.05). Results: There was no significant difference in NIP and SMIP values when the pre- and post-operative periods were compared for the ILG; however, these values were significantly lower for the CG, also with intergroup differences in NIP values. Atelectasis prevalence was 5% for ILG and 15% for CG, with no intergroup difference. Conclusion: The inspiratory muscle strength and resistance of the respiratory muscles were maintained in the group that performed exercises with inspiratory load associated with CRP, with a low rate of atelectasis after gastroplasty.

Highlights

  • The gastroplasty post-operative period can alter respiratory mechanics and predispose patients to respiratory complications

  • There was no significant difference in nasal inspiratory pressure (NIP) and sustained maximum inspiratory pressure (SMIP) values when the pre- and post-operative periods were compared for the Inspiratory Load Group (ILG); these values were significantly lower for the Control Group (CG), with intergroup differences in NIP values

  • The values for NIP, SMIP, Power and training index (TI) remained the same for ILG, but all variables changed for the CG

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Summary

Introduction

The gastroplasty post-operative period can alter respiratory mechanics and predispose patients to respiratory complications. Bariatric surgery is currently considered the gold-standard in the treatment of individuals with a body mass index (BMI) above 40 kg/m2, due to its greater effectiveness in the sustained weighted loss and reduction in the risk of death [1]. This surgical intervention can cause additional alterations in pulmonary function and in respiratory muscle contractibility. Diaphragmatic dysfunction can vary from partial losses in the capacity to generate pressure to the complete loss in diaphragmatic function [7], and, according to Franco et al [8], there is evidence that this is the main cause in the etiology of pulmonary complications. This could be due to the peak in dysfunction which occurs between two and eight hours after surgery, and its function is only reestablished after about fifteen days, according to Romanini et al [9]

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