Effects of a pre-operative home-based inspiratory muscle training programme on perceived health-related quality of life in patients undergoing coronary artery bypass graft surgery

K. Valkenet; J. C A Trappenburg; E. H. Hulzebos; N. L U van Meeteren; F. J G Backx

doi:10.1016/j.physio.2016.02.007

Effects of a pre-operative home-based inspiratory muscle training programme on perceived health-related quality of life in patients undergoing coronary artery bypass graft surgery

K. Valkenet^*, J. C A Trappenburg, E. H. Hulzebos, N. L U van Meeteren, F. J G Backx

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objectives: Pre-operative inspiratory muscle training has been shown to decrease the incidence of postoperative pneumonia and length of hospital stay in patients undergoing coronary artery bypass graft surgery (CABG). This study investigated if this decrease acted as a mediator on the time course of quality of life. Design: Complementary analyses of a published randomised controlled trial. Setting and participants: The initial trial included patients awaiting CABG surgery at a Dutch university hospital. The secondary analyses used data from the initial trial for patients who had completed at least one quality-of-life questionnaire. Methods: Participants were allocated at random to the intervention group or the usual care group. The intervention group followed a home-based pre-operative inspiratory muscle training programme. Quality of life was measured at five time points. Between-group differences in quality-of-life scores were analysed using mixed linear modelling. Results: The secondary analyses used data for 235 patients. In line with the initial trial, pneumonia and length of hospital stay were decreased significantly in the intervention group. The time courses for all patients showed significant improvements in quality of life after surgery compared with baseline. No significant differences in quality of life were observed over time between the two groups. Conclusion: Despite decreased incidence of pneumonia and length of hospital stay in the intervention group, this study did not find any improvements in quality of life due to the pre-operative home-based inspiratory muscle training programme. Clinical trial registration number: ISRCTN17691887.

Original language	English
Pages (from-to)	276-282
Number of pages	7
Journal	Physiotherapy
Volume	103
Issue number	3
DOIs	https://doi.org/10.1016/j.physio.2016.02.007
Publication status	Published - Sept 2017

Keywords

Coronary artery bypass graft surgery
Inspiratory muscle training
Quality of life

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10.1016/j.physio.2016.02.007

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@article{f03e758eaadb498eab9e1a17b0d52ddd,

title = "Effects of a pre-operative home-based inspiratory muscle training programme on perceived health-related quality of life in patients undergoing coronary artery bypass graft surgery",

abstract = "Objectives: Pre-operative inspiratory muscle training has been shown to decrease the incidence of postoperative pneumonia and length of hospital stay in patients undergoing coronary artery bypass graft surgery (CABG). This study investigated if this decrease acted as a mediator on the time course of quality of life. Design: Complementary analyses of a published randomised controlled trial. Setting and participants: The initial trial included patients awaiting CABG surgery at a Dutch university hospital. The secondary analyses used data from the initial trial for patients who had completed at least one quality-of-life questionnaire. Methods: Participants were allocated at random to the intervention group or the usual care group. The intervention group followed a home-based pre-operative inspiratory muscle training programme. Quality of life was measured at five time points. Between-group differences in quality-of-life scores were analysed using mixed linear modelling. Results: The secondary analyses used data for 235 patients. In line with the initial trial, pneumonia and length of hospital stay were decreased significantly in the intervention group. The time courses for all patients showed significant improvements in quality of life after surgery compared with baseline. No significant differences in quality of life were observed over time between the two groups. Conclusion: Despite decreased incidence of pneumonia and length of hospital stay in the intervention group, this study did not find any improvements in quality of life due to the pre-operative home-based inspiratory muscle training programme. Clinical trial registration number: ISRCTN17691887.",

keywords = "Coronary artery bypass graft surgery, Inspiratory muscle training, Quality of life",

author = "K. Valkenet and Trappenburg, {J. C A} and Hulzebos, {E. H.} and {van Meeteren}, {N. L U} and Backx, {F. J G}",

note = "Funding Information: In conclusion, this study supports the outcomes of the initial RCT on the prevention of postoperative pneumonia and decreasing LOS. However, the positive impact of IMT on these postoperative outcomes did not lead to enhanced recovery of QoL scores. Scientific efforts are needed to investigate whether IMT can also reduce pneumonia and LOS in other patients awaiting high-risk surgery, such as those awaiting oesophageal or pulmonary resection.?Ethical approval: The protocol (02/035-E) was approved by the Institutional Review Board and Ethics Committee of the University Medical Centre Utrecht, Utrecht, the Netherlands.?Funding: No funding was received for the current study. The initial RCT was funded by Project Grant 1310.0004 from the Netherlands Organisation for Health Research and Development; the Rudolf Magnus Institute of Neuroscience of the University Medical Centre Utrecht, Utrecht, the Netherlands; Agis Health Insurance House, Amersfoort; and the Royal Dutch Association of Physical Therapy. PT-Medical, the Netherlands supplied the inspiratory threshold loading devices.?Conflict of interest: None declared. Publisher Copyright: {\textcopyright} 2016 Chartered Society of Physiotherapy",

year = "2017",

month = sep,

doi = "10.1016/j.physio.2016.02.007",

language = "English",

volume = "103",

pages = "276--282",

journal = "Physiotherapy ",

issn = "0031-9406",

publisher = "Elsevier",

number = "3",

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Effects of a pre-operative home-based inspiratory muscle training programme on perceived health-related quality of life in patients undergoing coronary artery bypass graft surgery. / Valkenet, K.; Trappenburg, J. C A; Hulzebos, E. H. et al.
In: Physiotherapy , Vol. 103, No. 3, 09.2017, p. 276-282.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Effects of a pre-operative home-based inspiratory muscle training programme on perceived health-related quality of life in patients undergoing coronary artery bypass graft surgery

AU - Valkenet, K.

AU - Trappenburg, J. C A

AU - Hulzebos, E. H.

AU - van Meeteren, N. L U

AU - Backx, F. J G

N1 - Funding Information: In conclusion, this study supports the outcomes of the initial RCT on the prevention of postoperative pneumonia and decreasing LOS. However, the positive impact of IMT on these postoperative outcomes did not lead to enhanced recovery of QoL scores. Scientific efforts are needed to investigate whether IMT can also reduce pneumonia and LOS in other patients awaiting high-risk surgery, such as those awaiting oesophageal or pulmonary resection.?Ethical approval: The protocol (02/035-E) was approved by the Institutional Review Board and Ethics Committee of the University Medical Centre Utrecht, Utrecht, the Netherlands.?Funding: No funding was received for the current study. The initial RCT was funded by Project Grant 1310.0004 from the Netherlands Organisation for Health Research and Development; the Rudolf Magnus Institute of Neuroscience of the University Medical Centre Utrecht, Utrecht, the Netherlands; Agis Health Insurance House, Amersfoort; and the Royal Dutch Association of Physical Therapy. PT-Medical, the Netherlands supplied the inspiratory threshold loading devices.?Conflict of interest: None declared. Publisher Copyright: © 2016 Chartered Society of Physiotherapy

PY - 2017/9

Y1 - 2017/9

N2 - Objectives: Pre-operative inspiratory muscle training has been shown to decrease the incidence of postoperative pneumonia and length of hospital stay in patients undergoing coronary artery bypass graft surgery (CABG). This study investigated if this decrease acted as a mediator on the time course of quality of life. Design: Complementary analyses of a published randomised controlled trial. Setting and participants: The initial trial included patients awaiting CABG surgery at a Dutch university hospital. The secondary analyses used data from the initial trial for patients who had completed at least one quality-of-life questionnaire. Methods: Participants were allocated at random to the intervention group or the usual care group. The intervention group followed a home-based pre-operative inspiratory muscle training programme. Quality of life was measured at five time points. Between-group differences in quality-of-life scores were analysed using mixed linear modelling. Results: The secondary analyses used data for 235 patients. In line with the initial trial, pneumonia and length of hospital stay were decreased significantly in the intervention group. The time courses for all patients showed significant improvements in quality of life after surgery compared with baseline. No significant differences in quality of life were observed over time between the two groups. Conclusion: Despite decreased incidence of pneumonia and length of hospital stay in the intervention group, this study did not find any improvements in quality of life due to the pre-operative home-based inspiratory muscle training programme. Clinical trial registration number: ISRCTN17691887.

AB - Objectives: Pre-operative inspiratory muscle training has been shown to decrease the incidence of postoperative pneumonia and length of hospital stay in patients undergoing coronary artery bypass graft surgery (CABG). This study investigated if this decrease acted as a mediator on the time course of quality of life. Design: Complementary analyses of a published randomised controlled trial. Setting and participants: The initial trial included patients awaiting CABG surgery at a Dutch university hospital. The secondary analyses used data from the initial trial for patients who had completed at least one quality-of-life questionnaire. Methods: Participants were allocated at random to the intervention group or the usual care group. The intervention group followed a home-based pre-operative inspiratory muscle training programme. Quality of life was measured at five time points. Between-group differences in quality-of-life scores were analysed using mixed linear modelling. Results: The secondary analyses used data for 235 patients. In line with the initial trial, pneumonia and length of hospital stay were decreased significantly in the intervention group. The time courses for all patients showed significant improvements in quality of life after surgery compared with baseline. No significant differences in quality of life were observed over time between the two groups. Conclusion: Despite decreased incidence of pneumonia and length of hospital stay in the intervention group, this study did not find any improvements in quality of life due to the pre-operative home-based inspiratory muscle training programme. Clinical trial registration number: ISRCTN17691887.

KW - Coronary artery bypass graft surgery

KW - Inspiratory muscle training

KW - Quality of life

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U2 - 10.1016/j.physio.2016.02.007

DO - 10.1016/j.physio.2016.02.007

M3 - Article

C2 - 27569662

AN - SCOPUS:85003881379

SN - 0031-9406

VL - 103

SP - 276

EP - 282

JO - Physiotherapy

JF - Physiotherapy

IS - 3

ER -

Effects of a pre-operative home-based inspiratory muscle training programme on perceived health-related quality of life in patients undergoing coronary artery bypass graft surgery

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