Comparison investigation of The role of threshold loading inspiratory muscle training, with and without biofeedback, on pulmonary function, functional capacity and quality of life in in-patient phase of coronary artery bypass graft, before and after surgery

comparison the effect of the threshold loading inspiratory muscle training , with and without respiratory biofeedback, on the respiratory and functional capacity of patients in the hospitalization phase, before and after coronary artery bypass graft surgery .

A clinical trial with a control group, with parallel groups, a single blind , randomized by block method and stratification, on 50 patients.

Patients who are candidates for CABG surgery in the hospital, with informed consent of how interventions are performed in all groups, but without knowing how to group and with appropriate physical distance between groups, are entered into the study in a single blind manner. The first group performed 30 cycles of threshold inspiratory trainings at 30% load, with visual respiratory feedback and usual respiratory physiotherapy, twice a day, from the day before surgery until discharge. the second group, the intervention is similar to the first group, but without visual feedback, and in the control group, trainings are performed in the form of a placebo and with the usual physiotherapy.

Adult patients candidates for CABG surgery, between the ages of 50 and 80, in cardiac functional class 1 and 2, and without underlying respiratory disease and previous heart surgery, will be included in the study. Hemodynamic instability or the need for re-surgical intervention will cause the patient to exclude from the study.

first intervention group: inspiratory trainings, with respiratory biofeedback and usual respiratory physiotherapy. second intervention group: Similar to the first group and without respiratory biofeedback. Control group: inspiratory trainings in the form of placebo, with usual respiratory physiotherapy.

Inspiratory muscle strength; inspiratory flow; submaximal functional capacity

In this study, we have generally considered 3 intervention groups. And we use stratified and block method for randomization. At first, using the stratified technique and taking into account background factors including age (in two age groups, middle-aged and elderly), gender (male and female) and heart functional class (no symptoms and mild), in general 8 classes in is considered. Then, according to the volume of samples and in order to create a balance in the samples allocated to each of the studied groups, in each floor, we consider blocks of 3 people including 3 patients. And by using the random number table tool, we randomly assign each of the 3 patients to one of the groups. If the numbers were 1, 2, and 3, they would be assigned to group 1, if they were 4, 5, and 6, they would be assigned to group 2, and if they were 7, 8, and 9, they would be assigned to group 3.

The 3 treatment methods will be fully explained to the participants in this study, and they will also be informed that they will be assigned to one of these 3 groups, but about the way of randomization and allocation to groups, by The researcher and other health care workers do not find information. Then the intervention and evaluation is done in different groups in separate rooms, and when the samples are in the special section, the distance between the beds and the barrier between them is adjusted in such a way that it is impossible to exchange visual and auditory information, and how There is intervention between different groups for them. Also, the design of the intervention is such that in all three groups, the samples receive the desired intervention along with the usual treatment, which in the placebo group, the intervention is without creating a load and therefore ineffective.