This study evaluates the effects of the breath stacking technique in patients after upper abdominal surgery. Half of the patients receive routine physical therapy associated with the Breath Stacking technique, while the other half will receive only routine physical therapy.
This randomized controlled study aims to evaluate the effects of the Breath Stacking technique in patients undergoing upper abdominal surgery on clinical, physiological and cardiopulmonary variables. These individuals were randomized to compose the control group (CG) and the intervention group (GBS). The routine physical therapy was performed in both groups and in the GBS two daily sessions of up to 20 minutes of Breath Stacking technique were applied. To verify the effect of this intervention, before and after the protocol, patients underwent the following evaluations: algometry, cirtometry in the axillary line , umbilical line and the xiphoid process, ventilometry, spirometry and manovacuometry.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
32
The patients will perform the maneuver through successive inspiratory efforts for 20 s. Subsequently, the expiratory branch will be unobstructed to allow expiration. This maneuver will be repeated 5 times in each series, with intervals of 30 seconds between them. The technique will be performed with the trunk inclined 30º in relation to the horizontal plane, in 3 series, with interval of 2 min completing 15 min of therapy.
Federal University of Santa Maria
Santa Maria, Rio Grande do Sul, Brazil
Change from second postoperative day forced vital capacity (FVC) at 7th postoperative day or hospital discharge.
The FVC will be evaluated as recommended by the American Thoracic Society and European Respiratory Society (2006) and based on reproducibility and acceptability criteria, three maneuvers will be performed (variability \<5%) and considered the best curve for the study.
Time frame: The change in FVC will be evaluated on the 2nd postoperative day and up to 7th postoperative day.
Change from second postoperative day tidal volume at 7th postoperative day or hospital discharge.
Tidal volume will be obtained through the division of the minute volume by the respiratory rate.
Time frame: The change in tidal volume will be evaluated on the 2nd postoperative day and up to 7th postoperative day.
Heart rate
It will be evaluated with portable pulse oximeter.
Time frame: It will be evaluated on the 2nd postoperative day and up to 7th postoperative day. This variable will also be measured before and after the first and last BS session.
Respiratory rate
The respiratory rate will be measured by the movements of the rib cage during respiratory cycles performed in one minute.
Time frame: It will be evaluated on the 2nd postoperative day and up to 7th postoperative day. This variable will also be measured before and after the first and last BS session.
Blood pressure
Systolic and diastolic blood pressure will be verified by a stethoscope and sphygmomanometer.
Time frame: These will be evaluated on the 2nd postoperative day and up to 7th postoperative day. These will also be measured before and after the first and last BS session.
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Peripheral oxygen saturation (SpO2)
It will be evaluated with portable pulse oximeter.
Time frame: It will be evaluated on the 2nd postoperative day and up to 7th postoperative day. This variable will also be measured before and after the first and last BS session.
Painful perception in the surgical incision
The digital algometer will be used, which constitutes a dynamometer that exerts pressure with a rubber tip 1 cm in diameter on the skin, at a 90º angle, determining the pain threshold.
Time frame: It will be evaluated on the 2nd postoperative day and up to 7th postoperative day.
Thoracoabdominal mobility
The measuring tape will be positioned in three anatomical points: axillary fold, xiphoid appendix and umbilical line. The measurements will be performed at rest, after maximum inspiration and after maximum expiration.
Time frame: It will be evaluated on the 2nd postoperative day and up to 7th postoperative day.
Minute volume
To obtain the minute volume (MV), the patient will be instructed to inhale and exhale slowly using the Wright ® ventilometer (British Oxygen Company, London, England).
Time frame: It will be evaluated on the 2nd postoperative day and up to 7th postoperative day.
Forced expiratory volume in the first second (FEV1)
It will be evaluated as recommended by the American Thoracic Society and European Respiratory Society (2006) and based on reproducibility and acceptability criteria, three maneuvers will be performed (variability \<5%) and considered the best curve for the study.
Time frame: It will be evaluated on the 2nd postoperative day and up to 7th postoperative day.
FEV1 / FVC ratio (FEV1 / FVC)
It will be evaluated as recommended by the American Thoracic Society and European Respiratory Society (2006) and based on reproducibility and acceptability criteria, three maneuvers will be performed (variability \<5%) and considered the best curve for the study.
Time frame: It will be evaluated on the 2nd postoperative day and up to 7th postoperative day.
Peak expiratory flow (PEF)
It will be evaluated as recommended by the American Thoracic Society and European Respiratory Society (2006) and based on reproducibility and acceptability criteria, three maneuvers will be performed (variability \<5%) and considered the best curve for the study.
Time frame: It will be evaluated on the 2nd postoperative day and up to 7th postoperative day.
Forced expiratory flow between 25 and 75% of the curve of FVC (FEF25-75)
It will be evaluated as recommended by the American Thoracic Society and European Respiratory Society (2006) and based on reproducibility and acceptability criteria, three maneuvers will be performed (variability \<5%) and considered the best curve for the study.
Time frame: It will be evaluated on the 2nd postoperative day and up to 7th postoperative day.
Respiratory muscle strength
The maximal inspiratory and expiratory pressures will be evaluated with manovacuometer.
Time frame: These will be evaluated on the 2nd postoperative day and up to 7th postoperative day.
Degree of dyspnea
It will be evaluated using the modified Borg Scale, a vertical scale quantified from 0 to 10. Zero represents no symptoms and 10 represents the maximum of symptoms.
Time frame: It will be evaluated before and after the application of the BS technique (therefore, only in GBS) on the 2nd postoperative day and up to 7th postoperative day.
Rates of signs of respiratory discomfort (dizziness, tachypnea, sweating, use accessory musculature)
Evaluated through clinical inspection.
Time frame: These will be evaluated before and after the application of the BS technique (therefore, only in GBS) on the 2nd postoperative day and up to 7th postoperative day.
Rates of gastrointestinal symptoms (pain abdominal, nausea, vomiting)
Evaluated through clinical inspection.
Time frame: These will be evaluated before and after the application of the BS technique (therefore, only in GBS) on the 2nd postoperative day and up to 7th postoperative day.