The Effects of Inspiratory Muscle Training (IMT) on Patients Undergoing Coronary Artery Bypass Graft (CABG) Surgery: A Systematic Review and Meta-Analysis

Sisi Zhang¹, Bo Li², Xiaoping Meng³, Houjuan Zuo^1,*,†, Dayi Hu^1,*,†

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¹ Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430000 Wuhan, Hubei, China

² Department of Thoracic Surgery, The Second Hospital of Jilin University, 130041 Changchun, Jilin, China

³ Department of Cardiovascular and Cardiac Rehabilitation, The Affiliated Hospital of Changchun Traditional Chinese Medicine, 130000 Changchun, Jilin, China

^*Correspondence: zuohoujuan@126.com (Houjuan Zuo); hudayihust@126.com (Dayi Hu)
^†These authors contributed equally.
Academic Editor: Jerome L. Fleg

Rev. Cardiovasc. Med. 2023, 24(1), 16; https://doi.org/10.31083/j.rcm2401016

Submitted: 28 August 2022 | Revised: 22 September 2022 | Accepted: 22 September 2022 | Published: 9 January 2023

(This article belongs to the Special Issue Cardiac Rehabilitation—Volume 2)

This is an open access article under the CC BY 4.0 license.

Abstract

Background: To determine the effects of inspiratory muscle training (IMT) alone on inspiratory muscle strength and endurance, pulmonary function, pulmonary complications, and length of hospital stay in patients undergoing coronary artery bypass graft surgery (CABG). Methods: We conducted a literature search across databases (Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily; Ovid Embase; Ovid Cochrane Central Register of Controlled Trials; Ovid Cochrane Database of Systematic Reviews; and Scopus) from inception to December 2021. The eligibility criteria were randomized controlled trials that investigated the effects of IMT versus usual care or sham IMT in patients undergoing CABG. Results: A total of 12 randomized clinical trials with 918 patients were included in the meta-analysis. Postoperative IMT was associated with improved maximal inspiratory pressure (MIP), maximum inspiratory pressure (PImax), and six-minute walking test (6MWT) and with a decrease in length of hospital stay (LOS). For preoperative IMT, there was statistical significance between intervention and MIP, PImax, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), postoperative pulmonary complications (PPCs), and LOS. Pre- and postoperative IMT resulted in improvements in MIP. Conclusions: Isolated IMT in patients who underwent CABG improved their inspiratory muscle strength and endurance, pulmonary function, and 6MWT and helped decrease postoperative pulmonary complications and the length of hospital stay.

Keywords

inspiratory muscle training

coronary artery bypass graft surgery

pulmonary function

postoperative pulmonary complications

length of hospital stay

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Rev. Cardiovasc. Med. Print ISSN 1530-6550 Electronic ISSN 2153-8174