Skip to main content

Influence of Proprioceptive Neuromuscular Facilitation on Lung Function in Patients After Coronary Artery Bypass Graft Surgery

  • Chapter
  • First Online:
Clinical Medicine Research

Part of the book series: Advances in Experimental Medicine and Biology ((CLEXBI,volume 1116 ))

Abstract

Coronary heart disease is the most common cardiovascular disease. Primary prevention, medication, and invasive approach, along with the coronary artery bypass graft (CABG), are used in cardiovascular prophylaxis. Pulmonary rehabilitation, whose main task is to restore the patient’s optimum efficiency and prevent complications of the respiratory system, particularly resulting from limited physical activity and immobilization, plays an important role in the postsurgical treatment. The aim of this study was to evaluate the influence on lung function of proprioceptive neuromuscular facilitation (PNF) vs. standard physiotherapy in patients undergoing CABG surgery. The study included 42 patients scheduled for surgery, divided into PNF (n = 22; aged 62.3 ± 8.4) and standard rehabilitation (n = 20; aged 62.0 ± 7.4) groups. The findings demonstrate a decrease in post-surgery lung function in both groups. The increased ratios of FEV1/FVC and RV%TLC speak for a transient postoperative disturbance in lung function after surgery of restrictive character, accompanied by air trapping. We found a gradual improvement after 2 months of home rehabilitation, with a significant trend for a better outcome using PNF. We conclude that PNF holds a potential for optimizing the outcome of pulmonary rehabilitation after coronary bypass surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Aaron SD, Dales RE, Cardinal P (1999) How accurate is spirometry at predicting restrictive pulmonary impairment. Chest 115(3):869–873

    Article  CAS  Google Scholar 

  • Adler S, Beckers D, Buck M (2008) PNF in practice. Springer-Verlag, Berlin/Heidelberg, pp 1–19

    Google Scholar 

  • Berrizbeitia LD, Tessler S, Jacobowitz IJ, Kaplan P, Budzilowicz L, Cunningham JN (1989) Effect of sternotomy and coronary bypass surgery on postoperative pulmonary mechanics. Chest 96:873–876

    Article  CAS  Google Scholar 

  • Bravata DM, Gienger AL, McDonald KM, Sundaram V, Perez MV, Varghese R, Kapoor JR, Ardehali R, Owens DK, Hlatky MA (2007) Systematic review: the comparative effectiveness of percutaneous coronary interventions and coronary artery bypass graft surgery. Ann Intern Med 147(10):703–716

    Article  Google Scholar 

  • Cassar A, Holmes DR Jr, Rihal CS, Gersh BJ (2009) Chronic coronary artery disease: diagnosis and management. Mayo Clin Proc 84(12):1130–1146

    Article  CAS  Google Scholar 

  • Curtis JJ, Walls JT, Boley TM, Schmaltz RA, Demmy TL, Salam N (1994) Coronary revascularization in the elderly: determinants of operative mortality. Ann Thorac Surg 58:1069–1072

    Article  CAS  Google Scholar 

  • Dubach P, Myers J, Dziekan G, Goerre S, Buser P, Laske A (1995) Effect of residential cardiac rehabilitation following bypass surgery: observations in Switzerland. Chest 108:1434–1439

    Article  CAS  Google Scholar 

  • Dylewicz P, Jegier A, Piotrowicz R, Rudnicki S, Tylka J, Mazurek K, Przywarska I, Rybicki J, Zdrojewski T (2004) Comprehensive cardiac rehabilitation. The position of the Committee for Studies of cardiac rehabilitation standards polish cardiac society. Folia Cardiol 11(A):1–48

    Google Scholar 

  • Efthimiou J, Butler J, Woodham C, Benson MK, Westaby S (1991) Diaphragm paralysis following cardiac surgery: role of phrenic nerve cold injury. Ann Thorac Surg Oct 52(4):1005–1008

    Article  CAS  Google Scholar 

  • El-Kader SMA (2011) Blood gases response to different breathing modalities in phase I of cardiac rehabilitation. Program after coronary artery bypass graft. Eur J Gen Med 8(2):85–91

    Article  Google Scholar 

  • Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ, Thompson PD, Williams MA, Lauer MS (2005) Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation. Circulation 111(3):369–376

    Article  Google Scholar 

  • Montes FR, Maldonado JD, Paez S, Ariza F (2004) Off-pump versus on-pump coronary artery bypass surgery and postoperative pulmonary dysfunction. J Cardiothorac Vasc Anesth 18:698–703

    Article  Google Scholar 

  • Nichols M, Townsend N, Scarborough P, Rayner M (2014) Cardiovascular disease in Europe 2014: epidemiological update. Eur Heart J 35(42):2950–2959

    Article  CAS  Google Scholar 

  • Pack QR, Goel K, Lahr BD, Greason KL, Squires RW, Lopez-Jimenez F, Zhang Z, Thomas RJ (2013) Participation in cardiac rehabilitation and survival after coronary artery bypass graft surgery: a community based study. Circulation 128(6):590–597

    Article  Google Scholar 

  • Perk J, DeBacker G, Gohlke H, Graham I, Reiner Z, Verschuren WM (2012) European guidelines on cardiovascular disease prevention in clinical practice. The fifth joint task force of the European Society of Cardiology and Other Societies on cardiovascular disease prevention in clinical practice. Eur Heart J 33:1635–1701

    Article  CAS  Google Scholar 

  • Pinheiro AC, Magalhaes Novais MC, Neto MG, Herbst Rodrigues MV, de Souza Rodrigues E Jr, Aras R Jr, Carvalho VO (2011) Estimation of lung vital capacity before and after coronary artery bypass grafting surgery: a comparison on incentive spirometry and ventilometry. J Cardiothorac Surg 6:70

    Article  Google Scholar 

  • Rachwalik M, Lysenko L, Kustrzycki W, Pelczar M, Wachnik J (2006) Comparison of spirometry in patients after on-pump and off-pump coronary artery bypass grafting. Anaesthesiol Intensive Ther 1:6–10

    Google Scholar 

  • Rachwalik M, Pelczar M, Gozdzik A (2007) Postoperative, early and late pulmonary functions – off–pump vs. on–pump coronary artery bypass surgery. Pol J Thoracic Cardiovasc Surgery 4(3):252–260

    Google Scholar 

  • Shenkman Z, Shir Y, Weiss Y, Bleiberg B, Gross D (1997) The effects of cardiac surgery on early and late pulmonary functions. Acta Anaesthesiol Scand 41:1193–1199

    Article  CAS  Google Scholar 

  • Staton GW, Williams WH, Mahoney EM, Hu J, Chu H, Duke PG, Puskas JD (2005) Pulmonary outcomes of off-pump vs on-pump coronary artery bypass surgery in a randomized trial. Chest 127(3):892–901

    Article  Google Scholar 

  • Vaidya R, Husain T, Ghosh PK (1996) Spirometric changes after open mitral surgery. J Cardiovasc Surg 37(3):295–300

    CAS  Google Scholar 

  • Westerdahl E, Lindmark B, Almgren SO, Tenling A (2001) Chest physiotherapy after coronary artery bypass graft surgery – a comparison of three different deep breathing techniques. J Rehab Med 33:79–84

    Article  CAS  Google Scholar 

  • Westerdahl E, Lindmark B, Bryngelsson I, Tenling A (2003) Pulmonary function 4 months after coronary artery bypass graft surgery. Respir Med 97:317–322

    Article  CAS  Google Scholar 

  • Westerdahl E, Lindmark B, Eriksson T, Friberg Ö, Hedenstierna G, Tenling A (2005) Deep-breathing exercises reduce atelectasis and improve pulmonary function after coronary artery bypass surgery. Chest 128:3482–3488

    Article  Google Scholar 

  • Wynne R, Botti M (2004) Postoperative pulmonary dysfunction in adults after cardiac surgery with cardiopulmonary bypass: clinical significance and implications for practice. Am J Crit Care 13(5):384–393

    PubMed  Google Scholar 

Download references

Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Małgorzata Bujar-Misztal .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Bujar-Misztal, M., Chciałowski, A. (2018). Influence of Proprioceptive Neuromuscular Facilitation on Lung Function in Patients After Coronary Artery Bypass Graft Surgery. In: Pokorski, M. (eds) Clinical Medicine Research. Advances in Experimental Medicine and Biology(), vol 1116 . Springer, Cham. https://doi.org/10.1007/5584_2018_243

Download citation

Publish with us

Policies and ethics