Article

OBJECTIVE: To evaluate whether preoperative inspiratory muscle training is
effective in preventing postoperative pulmonary complications and reducing length
of hospital stay in people undergoing cardiothoracic or upper abdominal surgery.
DATA SOURCES: Medline, CINAHL, AMED, PsychINFO, Scopus, PEDro, and the Cochrane
Library. REVIEW METHODS: A systematic review and meta analysis of randomized
controlled trials (or quasi-randomized controlled trials) investigating a form of
preoperative inspiratory muscle training, compared with sham or no inspiratory
muscle training. Participants were adults (16 years and over) awaiting elective
open cardiac, thoracic, or upper abdominal surgery. Methodological quality was
assessed using the PEDro scale. RESULTS: Eight studies involving 295 participants
were eligible for inclusion. The trained group had significantly higher maximal
inspiratory pressure at the end of the preoperative training period (mean
difference: 15 cm H2O, 95% confidence interval (CI): 9 to 21). This benefit was
maintained through the early postoperative period, when lung function also
recovered significantly more quickly in the trained group. Inspiratory muscle
training also substantially reduced postoperative pulmonary complications
(relative risk 0.48, 95% CI 0.26 to 0.89). Although not statistically
significant, length of hospital stay also tended to favour the trained group.
There were no statistically significant differences between the groups for the
remaining outcomes. Participant satisfaction with inspiratory muscle training was
high. CONCLUSION: Preoperative inspiratory muscle training significantly improves
respiratory (muscle) function in the early postoperative period, halving the risk
of pulmonary complications. The training does not increase length of stay, but
more data are required to confirm whether it reduces length of stay.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS