Efeitos da fisioterapia respiratória pré-operatória em pacientes candidatos à cirurgia bariátrica / Effect of preoperative chest physiotherapy on candidates for bariatric surgery

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

BACKGROUND: Obesity is an increasingly prevalent universal disease acquiring epidemic proportions and is one of the main problems of modern public healthcare. There is consensus that the clinical approach is usually ineffective in more serious cases of obesity and bariatric surgery constitutes a better treatment option. Bariatric surgery is currently the best therapeutic modality for massive weight loss maintained over time and consequently offers a cure or control of associated diseases, which is its main goal. AIM: The aim of the present study was to determine the effect of an intensive preoperative chest physiotherapy program on morbidly obese patients scheduled to undergo bariatric surgery with the intention of improving lung function and verify the relationship between clinical (sleep apnea and spirometry) and circumferences of the neck, chest and abdominal. MATERIALS AND METHODS: Thirty-four morbidly obese candidates for bariatric surgery with clinical symptoms of sleep apnea (snoring, restless sleep, morning headaches and excessive daytime sleep) and/or a restrictive, obstructive, nonspecific or mixed spirometry pattern were selected. The selection of patients for surgical treatment was supervised by the Department of Obesity Surgery of the University Hospital of the University of São Paulo. Patients were selected based on their availability regarding the preoperative therapy, willingness to participate in the study and having signed a term of informed consent. Male and female participants between 20 and 75 years of age were included. All were submitted to preoperative chest physiotherapy program and two evaluations: 15 days prior to surgery and a second 1 day prior to surgery. The following variables were analyzed: circumference of the neck, chest, abdomen and hip; body mass index (BMI); respiratory rate (RR); arterial oxygen saturation (SpO2); slow vital capacity (SVC); minute volume (Vol-min); maximal inspiratory pressure (MIP); spirometry; Borg Rate of Perceived Exertion (RPE); and clinical signs of sleep apnea. Two groups: control group (G1) and experimental group (G2). The G2 was submitted a program of preoperative respiratory therapy. RESULTS: There were favorable significant differences between evaluations for the following variables: FEV1/FVC 1 and VEF1/CVF 2 of G1 and G2 (p-valor =0.030 and 0.005) MIP (p = 0.032); RR (p = 0.001); Borg RPE (p = 0.001); SpO2 (p = 0.001) of G2. CONCLUSION: A chest physiotherapy program is capable of improving lung volume, lung capacity and respiratory muscle strength in morbidly obese patients in preoperative preparation for bariatric surgery. There is correlation between thorax and abdominal circumference and clinical symptoms of obstructive sleep apnea.

ASSUNTO(S)

espirometria spirometry physical therapy modalities modalidades de fisioterapia cirurgia bariátrica obesidade mórbida bariatric surgery exercícios respiratórios obesity morbid breathing exercises

ACESSO AO ARTIGO

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