Influence of Different Physical Therapy Resources Application After Abdominal Surgery
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Pulmonary Atelectasis
- Sponsor
- Universidade Metodista de Piracicaba
- Enrollment
- 140
- Locations
- 1
- Primary Endpoint
- Pulmonary function
- Status
- Completed
- Last Updated
- 12 years ago
Overview
Brief Summary
The aim of this study will be to investigate the effects of using physical therapy resources in the postoperative morbidly obese individuals undergoing gastroplasty.
It is believed that the application of these various features of physiotherapy after abdominal surgery may contribute differently in restoring lung function and prevention of pulmonary complications and can thus identify the resources that can contribute more effectively in post-operative bariatric surgery.
Detailed Description
The aim of this study will be to investigate the effects of using physical therapy resources in the postoperative morbidly obese individuals undergoing Roux-en-Y gastric by-pass with regard to: lung volumes and capacities, prevalence of atelectasis, thoracoabdominal mobility and evaluation of peak flow of cough, evaluated pre and post operative. Individuals with BMI between 40 and 55 Kg/m², aged between 25 and 55 years, underwent the surgical procedure Roux-en-Y type gastric by-pass by laparotomy and normal preoperative pulmonary function will be included. The volunteers will be divided into seven different groups, according to the treatment received during hospitalization after surgery: G control: subjects treated with conventional physiotherapy according to the routine service of physiotherapy of the hospital; G Voldyne: subjects treated with incentive spirometry, Voldyne Model 5000® (Sherwood Medical, USA); G CPAP: subjects treated with "continuous positive airway pressure"; G EPAP: subjects treated with "expiratory positive airway pressure"; G IPPB: subjects treated with "intermittent positive pressure breathing"; G BIPAP: subjects treated with "bi-level positive airway pressure"; G BS: subjects treated with "breath stacking" (siliconized mask connected to a unidirectional valve allowing only inspiration). The application of resources will be held twice a day in the immediate and in the first postoperative sessions in 6 sets of 15 reps or 30 continuous minutes, with an interval of 4 hours between sessions. The researcher will remain alongside the volunteers, following them and monitoring vital signs and respiratory comfort.
Investigators
Eli Maria Pazzianotto Forti
PhD
Universidade Metodista de Piracicaba
Eligibility Criteria
Inclusion Criteria
- •BMI between 40 and 55 Kg/m²
- •Aged between 25 and 55 years
- •Submitted to Roux-en-Y type gastric by-pass by laparotomy
- •Normal preoperative pulmonary function test
Exclusion Criteria
- •Hemodynamic instability
- •Hospital stay longer than three days
- •Presence of postoperative complications
Outcomes
Primary Outcomes
Pulmonary function
Time Frame: 2 days after surgery
Spirometry was carried out according to the guidelines of the American Thoracic Society (ATS) and European Respiratory Society (ERS) (2005). Three types of maneuver were used in order to evaluate the lung volumes and flows: Slow Vital Capacity (SVC), Forced Vital Capacity (FVC) and Maximum Voluntary Ventilation (MVV). The maneuvers were carried out until three acceptable and reproducible curves were obtained, not exceeding more than eight attempts. The values extracted from each maneuver were selected according to Pereira (2002), and the predicted values calculated using the equation proposed by Pereira et al. (1992) for Brazilians.
Secondary Outcomes
- Prevalence of atelectasis(2 days after surgery)
- Thoracoabdominal mobility(2 days after surgery)
- Peak cough flow(2 days after surgery)