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Benefits of postoperative respiratory kinesiotherapy following laparoscopic cholecystectomy
Gastaldi AC, Magalhaes CMB, Barauna MA, Silva EMC, Souza HCD
Revista Brasileira de Fisioterapia [Brazilian Journal of Physical Therapy] 2008 Mar-Apr;12(2):100-106
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

INTRODUCTION: Pulmonary function changes following abdominal surgery lead to reduced pulmonary volume, thus compromising gas exchanges. OBJECTIVE: To evaluate the effects of respiratory kinesiotherapy on pulmonary function and respiratory muscle strength in patients who underwent laparoscopic cholecystectomy. METHODS: Twenty women and 16 men (age 48.4 +/- 9.55 years) who underwent laparoscopic cholecystectomy were prospectively studied. They were randomly divided as follows: 17 subjects performed breathing exercises (diaphragmatic respiration, maximum sustained inspiration and fractional inspiration) and 19 participated as a control group. All of them underwent evaluations of maximal inspiratory and expiratory pressures (MIP and MEP), peak expiratory flow (PEF) and spirometry, with measurements of vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and the FEV1/FVC ratio before the operation and daily until the sixth postoperative day (POD). RESULTS: The preoperative parameters were not statistically different between the two groups. Both groups presented decreases in all variables on the first POD (p < 0.05). The exercise group continued to present decreased values until the second POD for VC, FVC, and FEV1 (p < 0.05), until the third POD for MIP and PEF (p < 0.05) and the fourth POD for MEP (p < 0.05). For the control group, the values of all the variables began to normalize on the fifth POD. The MIP and MEP values in the exercise group were higher than those in the controls, from the third and second POD onwards, respectively. CONCLUSIONS: Respiratory kinesiotherapy contributed towards early recovery of pulmonary function and muscle strength among patients who had undergone laparoscopic cholecystectomy.

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