Effect of Respiratory Muscle Training on Cough Efficacy, FunctionalRecovery and Length of Stay Post-Open-Abdominal Surgery: ASingle Blinded Randomised Controlled Trial

Abstract

Introduction: Abdominal surgery is associated with post-operative depressed cough efficacy which results in the pooling of secretions, altered pulmonary function and an increased risk of postoperative pulmonary complications (PPCs) leading to a prolonged length of hospital stay (LOS). Physiotherapy interventions, such as respiratory muscle training (RMT), have been implemented post-abdominal surgery with the aim to enhancing inspiratory muscle strength. However, it is unclear whether the increased strength translates to an improved cough.

Aim: To assess the effect of RMT in comparison with conventional chest physiotherapy (DBEx) on cough efficacy, functional recovery and length of stay (LOS) post-abdominal surgery. 

Method: This is a single blinded randomized controlled trial with thirty-six (36) patients scheduled for elective abdominal surgery. Participants were
randomly assigned into experimental (Exp) and control (Ctl) groups. Exp Group received RMT & Early Mobilization (EM), Ctl Group received DBEx and EM. The outcome variables include; peak cough flow (PCF), functional recovery, LOS and pulmonary function. Inferential statistics of Analysis of Variance (ANOVA) was used to evaluate the significant difference in the 3 stages of data collection (pre-op, immediate post-op and post-op day 7 (POD7) or discharge(if discharged before POD7). Independent t-test was used to compare the outcome variables between the groups.

Result: 32 participants completed this study. In both groups, ANOVA showed a significant decrease in PCF, BIS and pulmonary function at immediate post-op followed by an increase at discharge or POD7. There was no statistically significant difference between the 2 groups following the t-test analysis in all variables.

Conclusion: RMT or DBEx in addition to EM will improve cough efficacy, functional recovery, LOS and pulmonary function post-abdominal surgery.
None is more effective than the other in the management of patients’ post-abdominal surgery.