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NCT Number: NCT06551714

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

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.

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Key information

Conditions

Open Heart Surgery Cardiovascular Disease Cardiovascular Diseases Physiotherapy

Age range

18 year–75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Lokman Hekim Akay Hospital

Ankara, 06000, Turkey (Türkiye)

Location status: Recruiting

Location contact

Feyza meraklı

PRINCIPAL_INVESTIGATOR

Physiotherapist

CONTACT

05427685223

Yasemin Buran Çırak

SUB_INVESTIGATOR

About this study

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).

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Phase 1 cardiac rehabilitation

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

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.

Primary outcomes

  1. İnspiratory muscle strength

    Time frame: Before and after treatment on each day of treatment, up to 3 month

    Maximum Inspiratory Pressure (MIP) - pressure

  2. Expiratory muscle strength

    Time frame: After and before treatment on each day of treatment, up to 3 month

    Maximum Expiratory Pressure (MEP) - pressure

  3. 2 Minute Walk Test

    Time frame: Before treatment on the first day of treatment and after treatment on the last day of treatment, up to 3 month

    It is walking as fast as the person can for 2 minutes without any assistance, at a safe distance of 30 meters. - meter

  4. Time Up and Go (TUG)

    Time frame: first day of treatment before treatment and last day of treatment after treatment, up to 3 month

    The person gets up from the chair, walks 3 meters, comes back and sits on the chair. - minute

  5. Vital sign

    Time frame: Before and after treatment on each day of treatment, up to 3 month

    Oxygen saturation

  6. Respiratory frequency

    Time frame: Before and after treatment on each day, up to 3 month

    Number of times a person inhales and exhales in 1 minute. - number

  7. Blood pressure

    Time frame: Before and after treatment on day of treatment, up to 3 month

    Blood pressure is the pressure of blood within the arteries of the circulatory system. - pressure

  8. Heart rate

    Time frame: Before and after treatment on each day of treatment, up to 3 month

    Number of times a person heart rate in 1 minute. - number

  9. Life quality

    Time frame: Before treatment on the first day of treatment and after treatment on the last day of treatment, up to 3 month

    The Minnesota Living with Heart Failure Questionnaire

  10. Depression

    Time frame: Before treatment on the first day of treatment and after treatment on last day of treatment, up to 3 month

    Beck's depression inventory

  11. Symptom

    Time frame: Before and after treatment on each day of treatment, up to 3 month

    Dyspnea

Study contacts

Contact information is provided by the study sponsor or research team.

Feyza merakli

CONTACT

[email protected]

05427685223 ext. 0606

Gungor

CONTACT

Sponsors and collaborators

Lead sponsor

Dogus Universitesi

Other

Registry information

Official study title

The Effect of Neurophysiological Facilitation Techniques on Pulmonary Function, Respiratory Muscle Strength and Functional Capacity in The Early Stage After Open Heart Surgery

Important dates

Study start
2024
Primary completion
2024
Study completion
2024
First posted
Aug 13, 2024
Registry last updated
Aug 13, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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