NCT02298517

Brief Summary

The aim of this study is to evaluate the effects of the use of breathing exercises with inspiratory loading on respiratory muscle strength and endurance, lung volumes and capacities and thoracoabdominal mobility in patients after bariatric surgery. It is believed that the use of inspiratory load may mitigate the negative effects of surgical trauma on respiratory muscle dysfunction, preserving respiratory muscle strength, lung volumes and diaphragm mobility, thus reducing the risk of pulmonary complications in the postoperative period.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
114

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Dec 2013

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

December 1, 2013

Completed
11 days until next milestone

First Submitted

Initial submission to the registry

December 12, 2013

Completed
10 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 1, 2014

Completed
2 months until next milestone

First Posted

Study publicly available on registry

November 24, 2014

Completed
7 days until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2014

Completed
Last Updated

May 28, 2015

Status Verified

May 1, 2015

Enrollment Period

10 months

First QC Date

December 12, 2013

Last Update Submit

May 27, 2015

Conditions

Keywords

Morbid obesitybariatric surgeryRespiratory muscle enduranceRespiratory muscle strengthspirometryphysiotherapy

Outcome Measures

Primary Outcomes (1)

  • EVALUATION OF INSPIRATORY MUSCLE ENDURANCE

    The endurance test is performed using the Power breathe ® K3. According to Basso and Costa (2012), this assessment divided into two tests: * Test incremental: starting with 10 centimeters of water, the volunteer is instructed to breathe normally for two minutes, thereafter a further minute, the next two minutes of exercise load will be increased, and so on until the volunteer fails to reach the predetermined pressure for three consecutive breaths or present dyspnea and / or fatigue. The largest load that is sustained for at least one minute will be considered the value of sustained maximal inspiratory pressure (PImáxS). * Test constant: is conducted PImáxS to 80%, which is obtained in the previous test, and determined the time limit (Tlim) run 30 minutes. The stopping criteria are the same as the incremental test.

    Preoperatively and on the high hostitalar - On day 1 and day 3

Secondary Outcomes (1)

  • EVALUATION OF LUNG VOLUMES AND CAPACITIES

    Preoperatively and on the high hostitalar - On day 1 and day 3

Other Outcomes (2)

  • THORACOABDOMINAL MOBILITY

    Preoperatively and on the high hostitalar - On day 1 and day 3

  • EVALUATION OF MUSCLE STRENGTH INSPIRATORY

    Preoperatively and on the high hostitalar - On day 1 and day 3

Study Arms (5)

Control

NO INTERVENTION

Individuals will be treated with conventional physiotherapy according to the routine service of physiotherapy of the hospital.

Incentive spirometry to flow

EXPERIMENTAL

Was determined for this study that the flow of inspired air will be sufficient to raise up to three spheres. In addition to direct them to do explosive, fast and deep, lifting the ball explosively breaths. Every fifteen inspirations volunteers will be invited to rest for intervals of 30-60 seconds and repeat six times. The use of incentive spirometry was adapted from the recommendations of the American Association for Respiratory Care (1991).

Procedure: incentive spirometry

incentive spirometry to volume

EXPERIMENTAL

Use of this incentive spirometry will be done as follows: the participants will be instructed to inhale deeply through the mouthpiece, to total lung capacity, starting from functional residual capacity. Will be performed 6 sets of 15 breaths each (deep, slow and sustained) intervals with 30-60 seconds between each series.

Procedure: incentive spirometry

inspiratory load equipment-Threshold

EXPERIMENTAL

This group will use the device Threshold™. Where adjustment is considered 40% of PNSN achieved by the patient evaluation. The volunteer will be instructed to remain in a supine position with 45 ° fowler comfortably with arms and shoulders relaxed and perform an inspiration with enough force to overcome the linear load of the device, then make a normal expiration. This study was determined to carry six sets of 15 repetitions. The rest will be about one to two minutes in each intervention.

Procedure: inspiratory load equipment

inspiratory load equipment-Power breathe

EXPERIMENTAL

To exercise inspiratory muscle in this group will be used device Power breathe ® K2 have the same resistance setting, allowing us to tailor your level of inspiratory muscles. Such adjustment will be made considering 40% of PNSN achieved by the patient in the assessment sniff. For its implementation, the patient will be lying with a tilt of the head of the litter at 45 °, the patient will be asked to inspire to overcome the resistance of the linear unit and after performing a normal expiration. This group will also be achieved 6 series with 15 repetitions each, with an interval of one to two minutes between sets.

Procedure: inspiratory load equipment

Interventions

Incentive spirometry to flow and incentive spirometry to volume

Incentive spirometry to flowincentive spirometry to volume

Threshold and Power breathe

inspiratory load equipment-Power breatheinspiratory load equipment-Threshold

Eligibility Criteria

Age25 Years - 55 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64)

You may qualify if:

  • BMI between 40 and 55 Kg/m²
  • Aged between 25 and 55 years
  • Submitted to Roux-en-Y type gastric by-pass by laparotomy
  • Normal preoperative pulmonary function test

You may not qualify if:

  • Hemodynamic instability
  • Hospital stay longer than three days
  • Presence of postoperative complications
  • Smoking

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Universidade Metodista de Piracicaba (UNIMEP) 13400911

Piracicaba, São Paulo, 13400911, Brazil

Location

Related Publications (1)

  • Pazzianotto-Forti EM, da Costa Munno CM, Merino DFB, Simoes da Rocha MR, de Mori TA, Junior IR. Effects of Inspiratory Exercise With Linear and Nonlinear Load on Respiratory Variables Post-Bariatric Surgery. Respir Care. 2019 Dec;64(12):1516-1522. doi: 10.4187/respcare.05841. Epub 2019 Aug 6.

MeSH Terms

Conditions

Pulmonary AtelectasisRespiratory Tract DiseasesPathological Conditions, Signs and SymptomsObesity, Morbid

Condition Hierarchy (Ancestors)

Lung DiseasesObesityOverweightOvernutritionNutrition DisordersNutritional and Metabolic DiseasesBody WeightSigns and Symptoms

Study Officials

  • Eli M Pazzianotto-Forti, PhD

    Universidade Metodista de Piracicaba

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
FACTORIAL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
PhD

Study Record Dates

First Submitted

December 12, 2013

First Posted

November 24, 2014

Study Start

December 1, 2013

Primary Completion

October 1, 2014

Study Completion

December 1, 2014

Last Updated

May 28, 2015

Record last verified: 2015-05

Locations