The effect of early mobilization protocol after open heart surgery on diaphragmatic muscle strength

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Lotfian Sara; Arian Hasan; Azarfarin Rasool; Bakhshandeh Hooman; Moradnejad Pardis

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Journal Paper

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Journal: Cardiovascular Nursing Journal Year:2022 | Volume: | Issue: Page(s): 80-86

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Title

The effect of early mobilization protocol after open heart surgery on diaphragmatic muscle strength

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Keywords

Cardiac surgeryQ4

DiaphragmQ4

Early mobilizationQ4

Muscle strengthQ4

Abstract

2ABSTRACT Aim. The aim of the present study was to examine the effect of Early mobilization protocol on the strength of Diaphragmatic muscle and other inspiratory muscles after open heart surgery. Background. Early mobilization is recommended as a safe protocol after open heart surgery to decrease hospital stay and post-op respiratory complications; however, our knowledge about its effect on improving respiratory muscles strength is limited. Methods. This is a randomized single-blinded clinical trial conducted on 80 consecutive patients who underwent coronary artery bypass surgery and/or valvular surgery that were randomly assigned to experimental group (postoperative Early mobilization) and control group (routine physiotherapy). On the day before surgery and the day before leaving intensive care unit (ICU), two scores were measured for assessing Diaphragmatic Muscle strength: maximum inspiratory pressure (PI max) and Strength index (S index). Hemodynamic parameters were also measured and compared. Findings. According to both PI max and S index, Diaphragmatic Muscle strength decreased from 77.28 to 59.53 cmH2O in patients after surgery, but the changes in the experimental group was less than the control group, which indicates a significant improvement in the strength of the Diaphragm muscle in the experimental group (p≤0.0001). Hemodynamic changes after surgery (lower blood pressure and increased heart rate) occurred in both groups without any significant clinical effect. Conclusion. Early mobilization after Cardiac surgery has positive effect on the strength of Diaphragmatic muscle and is also safe as shown to have no adverse effect on hemodynamic parameters.

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