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| Name | Class |
|---|---|
| Cheng-Hsin General Hospital | OTHER |
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The purpose of this clinical trial is to evaluate the effect of pilates-based cardiopulmonary physical therapy (CPT) for in-patients after cardiac surgery.
Postoperative pulmonary and musculoskeletal complications are the most frequent and significant contributor to morbidity, mortality with hospitalization. Pilates-based exercise has be applied to improve core control, movement efficiency and postural stability. High incidence of musculoskeletal problems have been concerned in relation to the patient's functional recovery after cardiac surgery. However, no literature is addressed how to manage this issue effectively till now. The purpose of this clinical trial is to evaluate the effect of pilates-based cardiopulmonary physical therapy for in-patients after cardiac surgery. This is a single-blinded, randomized control trial. Investigators will enroll pre-cardiac surgery and allocate subjects to modified Pilates-based training group or control group using block randomization.The training protocol will be based on pilates concepts. The control group is treated with a conventional protocol of physical therapy. The study will be carried on whole in-patient phase. During this period, patients received respiratory motion analysis, chest wall muscles mobility, lung function and endurance evaluation. Patients' changes in respiratory movement, cardiopulmonary endurance, and lung function will be evaluated by an assessor blinded to the intervention at admission and discharge from hospital. After 6 months after hospital discharge, patient's respiratory motion, lung function and disease specific health related quality of life will be evaluated. All outcomes will be described by mean (SD) or number (%). Independent t test or chi square test will be used to compare the basic data difference between training group and conventional group. Then, two-way analysis of variance or two-way analysis of covariance will be used to compare the outcomes difference between groups. Alpha level is set at 0.05.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pilates-based CPT | Experimental | incorporated the concept of pilates training into cardiopulmonary physical therapy after cardiac surgery |
|
| Traditional CPT | Active Comparator | usual bed side cardiopulmonary physical therapy after cardiac surgery |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pilates-based CPT | Behavioral | To emphasize the self-perception of breathing and body core control during in-patient cardiopulmonary physical therapy following cardiac surgery |
|
| Measure | Description | Time Frame |
|---|---|---|
| change from pre-operation in respiratory mechanics | Chest motion in deep breathing will be assessed simultaneously by 3D reality motion analysis and spirometer. Participants will be followed at hospital discharge, an expected average of 2 weeks after surgery. | at hospital discharge, an expected average of 2 weeks after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| change from pre-operation in respiratory mechanics | Chest motion in deep breathing will be assessed simultaneously by 3D reality motion analysis and spirometer. Participants will be followed at 6 month after surgery. | at 6 month after surgery |
| change from pre-operation in chest mobility |
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Inclusion Criteria:
Exclusion Criteria:
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 11772211 | Background | Grover FL, Cleveland JC Jr, Shroyer LW. Quality improvement in cardiac care. Arch Surg. 2002 Jan;137(1):28-36. doi: 10.1001/archsurg.137.1.28. | |
| 21189115 | Background | Lunardi AC, Marques da Silva CC, Rodrigues Mendes FA, Marques AP, Stelmach R, Fernandes Carvalho CR. Musculoskeletal dysfunction and pain in adults with asthma. J Asthma. 2011 Feb;48(1):105-10. doi: 10.3109/02770903.2010.520229. Epub 2010 Dec 29. |
| Label | URL |
|---|---|
| Postoperative complications among patients undergoing cardiac surgery | View source |
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| Traditional CPT | Behavioral | A traditional in-patient cardiopulmonary physical therapy following cardiac surgery including airway clearance, breathing exercises, chest mobility and reconditioning exercises and so on |
|
Chest mobility will be assessed by tape measuring the difference of chest circumference between deep inspiration and expiration. Participants will be followed at hospital discharge, an expected average of 2 weeks after surgery. |
| at hospital discharge, an expected average of 2 weeks after surgery |
| abnormal breathing pattern | Abnormal breathing pattern will be assessed by physical examination and camera recording if there is any paradoxical, asymmetrical chest movements during breathing. Participants will be followed at hospital discharge, an expected average of 2 weeks after surgery. | at hospital discharge, an expected average of 2 weeks after surgery |
| abnormal breathing pattern | Abnormal breathing pattern will be assessed by physical examination and camera recording if there is any paradoxical, asymmetrical chest movements during breathing. Participants will be followed at 6 month after surgery. | at 6 month after surgery |
| Percentage change from preoperative pulmonary function | Percentage of preoperative pulmonary function, including forced vital capacity (FVC), the first second forced expiratory volume (FEV1), peak inspiratory flow and peak expiratory flow are measured by spirometry at hospital discharge, an expected average of 2 weeks after cardiac surgery | at hospital discharge, an expected average of 2 weeks after surgery |
| Percentage change from preoperative pulmonary function | Percentage of preoperative pulmonary function, including forced vital capacity (FVC), the first second forced expiratory volume (FEV1), peak inspiratory flow and peak expiratory flow are measured by spirometry at 6 month after surgery | at 6 month after surgery |
| change of cardiopulmonary fitness | Six-minute walking test is used to assess cardiopulmonary fitness at hospital discharge, an expected average of 2 weeks after cardiac surgery. | at hospital discharge, an expected average of 2 weeks after cardiac surgery |
| cardiopulmonary exercise function | Symptom-limited graded exercise testing is used to assess cardiopulmonary exercise function at one month after hospital discharge. | at one month after hospital discharge |
| health related quality of life | Cardiovascular Limitations and Symptoms Profile (37 items) is used to assess disease specific health related quality of life at 6 month after hospital discharge. | at 6 month after hospital discharge |
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