Chest
Physio-Therapy: Clinical InvestigationsPreoperative Respiratory Muscle Training: Assessment in Thoracic Surgery Patients With Special Reference to Postoperative Pulmonary Complications
Section snippets
Patients
We studied 50 consecutive patients who underwent thoracic surgery between June 1992 and June 1993 (Table 1). Cases with pneumothorax were excluded because of the impossibility of measuring the values of MIP and MEP due to intrathoracic air leakage. There were 37 men and 13 women aged 24 to 73 years old (55±13 [SD]). Their diseases were lung tumor in 31, mediastinal tumor in 6, chronic empyema in 6, chest wall tumor in 2, giant bulla in 2, and esophageal tumor in 3 patients. Mean body surface
RESULTS
In the training group (patients undergoing thoracic surgery), the percent VC before and after respiratory muscle training was 93.7±20.9 and 95.1 ± 20.5 percent, respectively, and the corresponding FEV1 percent was 78.0±8.6 and 78.5±8.7 percent. In the control group, percent VC at the first and the second measurements was 101±15.9 and 100±16.1 percent, respectively, and the corresponding FEV1 percent was 78.8±8.5 and 79.2±8.5 percent. There were no significant differences in either group between
DISCUSSION
The present study demonstrates that preoperative respiratory muscle training increases the strength of both inspiratory and expiratory muscles. The muscles used for inspiration are the diaphragm, external intercostals, sternocleidomastoid, scalenes, serratus anterior, pectoralis major, pectoralis minor, trapezius, and erector spinae muscles. Of these, the first two muscles are used in normal inspiration.8 In contrast, normal expiration is a passive process, occurring when the intercostal
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