The Effect of Neurophysiological Facilitation Techniques on Health Parameters in Early Stages After Open Heart Surgery

NCT ID: NCT06551714

Last Updated: 2024-08-13

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 32 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-01-01
• Study Completion Date: 2024-11-01

Brief Summary

In this study, researchers aimed to investigate effects of neurophysiological facilitation on functional capacity and respiratory parameters of patients who underwent open heart surgery.

Do neurophysiological facilitation techniques improve individuals' respiratory parameters more than phase 1 cardiac rehabilitation?

Do neurophysiological facilitation techniques improve individuals' functional capacity more than phase 1 cardiac rehabilitation?

Researchers will apply phase 1 cardiac rehabilitation to both groups to see the effectiveness of neurophysiological facilitation techniques.

Detailed Description

In this study, researchers aimed to investigate effects of neurophysiological facilitation on functional capacity and respiratory parameters of patients who underwent open heart surgery.

The study was performed on 32 patients who underwent open heart surgery. Patients divided into two groups which study group (n=18) and control group (n=14).

Range of motion, breathing and mobilization exercises within the scope of phase 1 cardiac rehabilitation program were applied to the control group; in addition to the phase 1 cardiac rehabilitation program, neurophysiological facilitation techniques (perioral stimulation, intercostal tension, anterior basal lift, vertebral pressure, moderate manual pressure and abdominal co-contraction) were applied to the study group.

Sociodemographic features and disease-specific findings were recorded on the first postoperative day .

Vital signs, functional capacity, pulmonary function, fatigue and dyspnea of every patient were recorded before and after each treatment on the first four postoperative days.

Functional capacity was evaluated using Timed Up and Go (TUG) test and 2-Minutes Walking test (2MWT). Pulmonary function was examined using a peak flow meter and respiratory muscle strength was measured using an intraoral pressure measurement device. In addition, fatigue and dyspnea perception was measured using Modified Borg Scale.

Before the first day treatment and after the last day treatment of the four-day treatment, patients' fatigue severity were assessed with using Fatigue Severity Scale (FSS), anxiety and depression level with using Hospital Anxiety Depression Scale (HADS), fear of movement with using TAMPA Kinesiophobia Scale and life quality with using the Minnesota Heart Failure Questionnaire.

Before each treatment chest circumference measurements were taken, and the perceived pain severity was recorded using Visual Analog Scale (VAS).

Conditions

Open Heart Surgery; Cardiovascular Disease; Physiotherapy

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Control Group

Phase 1 cardiac rehabilitation

Group Type: EXPERIMENTAL

Phase 1 cardiac rehabilitation

Intervention Type: PROCEDURE

Day 1:Patients were informed about the surgery, positioning and mobilization.Range of motion (ROM), respiratory control, diaphragmatic breathing, pursed lip breathing, thoracal expansion exercises, assisted coughing,forced expiration techniques, which are the components of active breathing techniques cycle (ABTC), were taught.The use of incentive spirometry (IS) was demonstrated.Patients were performed 10 repetitions of IS exercises, and 5 repetitions ABTC and were asked to repeat them every hour.The patient was made to sit for 10 minutes and was walked 60 meters twice a day.

2:ROM, IS and diaphragmatic breathing exercises were applied 10 times each.ABTC was repeated in 5 sets. 120 meters was walked 5 times during the day.

3:Sitting time was increased to 30 minutes and walking distance was increased to 240 meters.5 steps were climbed.

4:Walking distance was increased to 360 meters.One flight of stairs was climbed.Discharge training was given.

Study Group

Neurophysiological facilitation techniques in addition to phase 1 cardiac rehabilitation techniques

Group Type: ACTIVE_COMPARATOR

Phase 1 cardiac rehabilitation

Intervention Type: PROCEDURE

Day 1:Patients were informed about the surgery, positioning and mobilization.Range of motion (ROM), respiratory control, diaphragmatic breathing, pursed lip breathing, thoracal expansion exercises, assisted coughing,forced expiration techniques, which are the components of active breathing techniques cycle (ABTC), were taught.The use of incentive spirometry (IS) was demonstrated.Patients were performed 10 repetitions of IS exercises, and 5 repetitions ABTC and were asked to repeat them every hour.The patient was made to sit for 10 minutes and was walked 60 meters twice a day.

2:ROM, IS and diaphragmatic breathing exercises were applied 10 times each.ABTC was repeated in 5 sets. 120 meters was walked 5 times during the day.

3:Sitting time was increased to 30 minutes and walking distance was increased to 240 meters.5 steps were climbed.

4:Walking distance was increased to 360 meters.One flight of stairs was climbed.Discharge training was given.

Neurophysiological facilitation techniques

Intervention Type: PROCEDURE

In addition to the phase 1 cardiac rehabilitation program for the group receiving neurophysiological facilitation (NPF) techniques:

NPF techniques such as perioral stimulation, intercostal tension, anterior basal lift, vertebral pressure, moderate manual pressure and abdominal co-contraction were applied for ten times for ten seconds.

Diaphragm facilitation exercise was performed by inhaling against resistance and holding the breath against resistance for 5 seconds.

Unilateral and bilateral upper extremity proprioceptive neuromuscular facilitation (PNF) movements combined with breathing were performed.

NPF techniques were performed 10 times each day throughout the treatment, while other applications (diaphragm facilitation, combined breathing exercise with upper extremity PNF technique and respiratory facilitation) were performed 5 times on the first day and 10 times on the other three days.

Interventions

Phase 1 cardiac rehabilitation

Day 1:Patients were informed about the surgery, positioning and mobilization.Range of motion (ROM), respiratory control, diaphragmatic breathing, pursed lip breathing, thoracal expansion exercises, assisted coughing,forced expiration techniques, which are the components of active breathing techniques cycle (ABTC), were taught.The use of incentive spirometry (IS) was demonstrated.Patients were performed 10 repetitions of IS exercises, and 5 repetitions ABTC and were asked to repeat them every hour.The patient was made to sit for 10 minutes and was walked 60 meters twice a day.

2:ROM, IS and diaphragmatic breathing exercises were applied 10 times each.ABTC was repeated in 5 sets. 120 meters was walked 5 times during the day.

3:Sitting time was increased to 30 minutes and walking distance was increased to 240 meters.5 steps were climbed.

4:Walking distance was increased to 360 meters.One flight of stairs was climbed.Discharge training was given.

Intervention Type: PROCEDURE

Neurophysiological facilitation techniques

In addition to the phase 1 cardiac rehabilitation program for the group receiving neurophysiological facilitation (NPF) techniques:

NPF techniques such as perioral stimulation, intercostal tension, anterior basal lift, vertebral pressure, moderate manual pressure and abdominal co-contraction were applied for ten times for ten seconds.

Diaphragm facilitation exercise was performed by inhaling against resistance and holding the breath against resistance for 5 seconds.

Unilateral and bilateral upper extremity proprioceptive neuromuscular facilitation (PNF) movements combined with breathing were performed.

NPF techniques were performed 10 times each day throughout the treatment, while other applications (diaphragm facilitation, combined breathing exercise with upper extremity PNF technique and respiratory facilitation) were performed 5 times on the first day and 10 times on the other three days.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Having open heart surgery for the first time,
• Being between the ages of 18-75,
• Being fully cooperative

Exclusion Criteria

• Having facial, sternum and rib fractures,
• Having chronic renal failure,
• Development of cerebrovascular accident,
• Having cognitive dysfunction,
• Development of deep vein thrombosis in the post-operative period,
• Having neuromuscular disease,
• Having an orthopedic disability,
• Intubation time longer than 24 hours,
• Staying in intensive care for more than 48 hours

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 75 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Dogus Universitesi

OTHER

Sponsor Role: lead

Responsible Party

Feyza Merakli

lecturer

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Yasemin Cirak, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

Istinye University

Feyza merakli

Role: STUDY_DIRECTOR

Istinye University

Locations

Lokman Hekim Akay Hospital

Ankara, , Turkey (Türkiye)

Site Status: RECRUITING

Countries

Turkey (Türkiye)

Central Contacts

Feyza merakli

Role: CONTACT

feyzamrkl@gmail.com

05427685223 ext. 0606

Gungor

Role: CONTACT

Facility Contacts

Physiotherapist

Role: primary

05427685223

Other Identifiers

DogusU

Identifier Type: -

Identifier Source: org_study_id