目的:本研究旨在确定吸气肌训练(IMT)对运动能力的影响,呼吸肌力量,住院时间(LOS),冠状动脉搭桥术后的生活质量(QOL)。
方法:根据系统评价和荟萃分析的首选报告项目(PRISMA)和Cochrane手册进行搜索,并包括数据库MEDLINE,EMBASE,CINAHL,Scopus,中央。该综述包括在冠状动脉旁路移植术后的患者中,在1期或2期术后心脏康复(PoCR)与替代治疗(主动或被动控制)期间使用IMT的随机对照试验。
结果:纳入了15项研究(11项1期研究,4项2期研究),无不良事件报告。在第一阶段PoCR中,IMT降低了LOS(-1.02天;95%CI=-2.00至-0.03)并增加了运动能力(6分钟步行距离[6MWD])。(+75.46米;95%CI=52.34至98.57),和最大吸气压力(MIP)(10.46cmH2O;95%CI=2.83至18.10),但对最大呼气压没有影响。在第二阶段PoCR中,IMT增加了6MWD(45.84米;95%CI=10.89至80.80),MIP(-23.19cmH2O;95%CI=-31.31至-15),最大呼气压(20.18cmH2O;95%CI=9.60至30.76),和生活质量(-11.17;95%CI=-17.98至-4.36),对峰值摄氧量没有影响。MIP(1期研究的75%)和6MWT(4项2期研究中的1项)存在较高的偏倚风险。证据的质量从非常低到中等。
结论:IMT显著提高了运动能力,呼吸肌力量,LOS,和QOL在阶段1和2PoCR。
结论:IMT可能会使PoCR的1期和2期患者受益,考虑到安全性,低成本,和潜在的好处。
OBJECTIVE: This study aimed to determine the effects of inspiratory muscle training (IMT) on exercise capacity, respiratory muscle strength, length of hospital stay (LOS), and quality of life (QOL) following coronary artery bypass graft surgery.
METHODS: The search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Cochrane Handbook and included the databases MEDLINE, EMBASE, CINAHL, Scopus, and CENTRAL. The review included randomized controlled trials utilizing IMT during phase 1 or 2 postoperative cardiac rehabilitation (PoCR) versus alternative treatment (active or passive control) in patients following coronary artery bypass graft surgery.
RESULTS: Fifteen studies were included (11 phase 1 studies, 4 phase 2 studies) with no reported adverse events. In phase 1 PoCR, IMT reduced the LOS (-1.02 days; 95% CI = -2.00 to -0.03) and increased exercise capacity (6-minute walk distance) (+75.46 m; 95% CI = 52.34 to 98.57), and maximal inspiratory pressure (MIP) (10.46 cm H2O; 95% CI = 2.83 to 18.10), but had no effect on maximal expiratory pressure. In phase 2 PoCR, IMT increased 6-minute walk distance (45.84 m; 95% CI = 10.89 to 80.80), MIP (-23.19 cm H2O; 95% CI = -31.31 to -15), maximal expiratory pressure (20.18 cm H2O; 95% CI = 9.60 to 30.76), and QOL (-11.17; 95% CI = -17.98 to -4.36), with no effect on peak oxygen uptake. There was a high risk of bias for MIP (75% of the phase 1 studies) and 6MWT (1 of 4 phase 2 studies). The quality of the evidence ranged from very low to moderate.
CONCLUSIONS: IMT significantly improves exercise capacity, respiratory muscle strength, LOS, and QOL in phase 1 and 2 PoCR.
CONCLUSIONS: IMT may benefit patients during phase 1 and 2 of PoCR, considering the safety, low cost, and potential benefits.