Preoperative respiratory strength training is feasible and safe and improves pulmonary physiologic capacity in individuals undergoing cardiovascular surgeryCentral MessagePerspective
Cara Donohue, PhD, CCC-SLP,
Lauren Wiele, MS, CCC-SLP,
Alyssa Terry, MS, CCC-SLP,
Eric Jeng, MD,
Thomas Beaver, MD,
Tomas Martin, MD,
Terrie Vasilopoulos, PhD,
Emily K. Plowman, PhD, CCC-SLP
Affiliations
Cara Donohue, PhD, CCC-SLP
Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Fla; Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Fla; Breathing Research and Therapeutics Center, University of Florida, Gainesville, Fla; Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, Tenn; Address for reprints: Cara Donohue, PhD, CCC-SLP, Department of Hearing and Speech Sciences, School of Medicine, Vanderbilt University, 1215 21st Ave South, Medical Center East Room 9221, Nashville, TN 37232.
Lauren Wiele, MS, CCC-SLP
Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Fla; Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Fla
Alyssa Terry, MS, CCC-SLP
Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Fla; Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Fla
Eric Jeng, MD
Department of Surgery, University of Florida, Gainesville, Fla
Thomas Beaver, MD
Department of Surgery, University of Florida, Gainesville, Fla
Tomas Martin, MD
Department of Surgery, University of Florida, Gainesville, Fla
Terrie Vasilopoulos, PhD
Department of Anesthesiology, University of Florida, Gainesville, Fla
Emily K. Plowman, PhD, CCC-SLP
Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Fla; Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Fla; Breathing Research and Therapeutics Center, University of Florida, Gainesville, Fla; Department of Surgery, University of Florida, Gainesville, Fla; Department of Neurology, University of Florida, Gainesville, Fla
Objective: To determine the safety, feasibility, and physiologic impact of a preoperative respiratory strength training (RST) program in individuals undergoing elective cardiac surgery (CS). Methods: Twenty-five adults undergoing an elective CS at an academic hospital setting enrolled and completed RST 5 days/week (50 repetitions, 50% training load, ≥3 weeks) at home via telehealth in this open-label prospective cohort study. RST adherence, telehealth attendance, and adverse events were tracked. Pre- and post-RST outcomes of maximum expiratory pressure (MEP), maximum inspiratory pressure (MIP), voluntary cough spirometry, and patient-reported dyspnea were collected. Descriptive analyses and Wilcoxon signed rank-tests were performed. Results: Two participants (9%) did not complete the prescribed RST program. No significant RST-related adverse events occurred. Treatment adherence for all enrolled participants was 90%, and telehealth attendance was 99%. Of the CS patients who completed the prescribed program (n = 23; 91%), treatment adherence and telehealth attendance were excellent (98% and 100%, respectively). Significant increases in primary outcomes were observed: MEP mean change, +15.4 (95% confidence interval [CI], +3.4 to +27.3, P .05). Conclusions: These preliminary data demonstrate that a preoperative RST program is safe and feasible and can improve short-term respiratory physiologic capacity (MEP and MIP) in CS patients. Future research is warranted to validate the current findings in a larger cohort of CS patients and to determine whether RST improves postoperative extubation outcomes, airway clearance capacity, and aspiration following cardiac surgery.
