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Effect of inspiratory muscle training associated or not to physical rehabilitation in preoperative anatomic pulmonary resection: a systematic review and meta-analysis

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Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Objective

The aim of this study is to systematically review the effect of inspiratory muscle training (IMT) associated or not with physical rehabilitation in the preoperative period of anatomical pulmonary resection.

Methods

Search in the databases: MEDLINE, Cochrane CENTRAL, EMBASE, LILACS and PEDro up to November 2019. Randomized clinical trials (RCTs) were included in adults in the preoperative period of pulmonary resection. The selection of studies and data extraction was performed by two independent reviewers. The risk of bias assessed with RoB 2.0 and the quality of evidence with GRADE. PROSPERO: CRD42018105859.

Results

Six RCTs were included; patients who underwent IMT in the preoperative period showed a significant improvement in functional capacity assessed by the 6-min walk test (6WT) (MD 28,93 [IC 95% 0,28; 57,58], p = 0,04, I2 = 0%) and significantly reduced the length of hospital stay (MD –3,63 [IC 95% −4,96; −2,29], p = 0,00, I2 = 0%). There was no significant difference between groups regarding pulmonary function, in postoperative complications such as pneumonia (RR 0,56 [IC 95% 0,29; 1,10], p = 0,09, I2 = 0%), atelectasis (RR 0,81 [IC 95% 0,24; 2,69], p = 0,72, I2 = 0%), mechanical ventilation > 48 h (RR 0,43 [IC 95% 0,12; 1,58], p = 0,20, I2 = 0%), in mortality (RR 0,33 [IC 95% 0,04; 3,12], p = 0,33, I2 = 0%), and quality of life.

Conclusion

IMT associated with physical exercise in the preoperative period of pulmonary resection improves functional capacity and reduces the length of hospital stay in the postoperative period.

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Data availability

All authors ensure that the data produced and the materials and the code number (PROSPERO CRD42018105859) are their own and materials used by other authors are properly identified. The manuscript and all its data support the authors’ statements and comply with the journal’s standards.

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Authors and Affiliations

  1. Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Street Sarmento Leite, 245, Porto Alegre, RS, 90050-170, Brazil

    Cindy de Oliveira Vacchi, Bianca Andrade Martha &  Fabrício Edler Macagnan

  2. Department of Physiotherapy, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil

    Fabrício Edler Macagnan

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Contributions

All authors contributed to the study conception and design. The idea for the article was performed by Cindy de Oliveira Vacchi, the literature search and data analysis were performed by Cindy de Oliveira Vacchi and Bianca Andrade Martha, and the manuscript was critically revised by Fabrício Edler Macagnan. The first draft of the manuscript was written by Cindy de Oliveira Vacchi, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Cindy de Oliveira Vacchi.

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de Oliveira Vacchi, C., Martha, B.A. & Macagnan, .E. Effect of inspiratory muscle training associated or not to physical rehabilitation in preoperative anatomic pulmonary resection: a systematic review and meta-analysis. Support Care Cancer 30, 1079–1092 (2022). https://doi.org/10.1007/s00520-021-06467-4

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