Effects of Respiratory Muscle Training Integrated Rehabilitation on Post-Operative Recovery after Cardiac Surgery

Abstract

Background: Cardiac surgery commonly leads to reduced lung capacity, weak respiratory muscles, and limited mobility during the early post-operative period. In Pakistan, structured cardiac rehabilitation is not routinely practiced, and Respiratory Muscle Training is rarely included as part of standard physiotherapy. Considering limited resources and the high burden of post-operative complications, there is a need to assess simple, low-cost interventions that can support faster recovery in local cardiac care units. Objective: To evaluate the effect of integrating respiratory muscle training into a structured rehabilitation program on post-operative recovery among cardiac surgery patients in Pakistan. Methodology: This quasi-experimental study was conducted at Punjab Institute of Cardiology, Lahore, Pakistan, from August to November 2024. A total of 60 post-operative cardiac surgery patients were recruited through non-probability consecutive sampling and allocated into an intervention group (n=30) and a control group (n=30). The intervention group received respiratory muscle training-integrated rehabilitation, including incentive spirometry, diaphragmatic breathing, inspiratory muscle training using a threshold device, early mobilization, and graded functional activity for 7 consecutive days. The control group received routine post-operative physiotherapy. Lung function tests, inspiratory muscle strength, and functional capacity were recorded on day 1 and 7. Data were analysed using SPSS version 26, with p <0.05 considered significant. Paired t-tests were used to compare pre- and post-intervention results within each group, while independent t-tests compared changes between groups. Results: The intervention group showed significantly greater improvement in lung function tests, inspiratory muscle strength, and 6-minute walk test distance (p<0.01) compared to the control group. Reduced pulmonary complications and a shorter hospital stay were also observed. Conclusion: Respiratory muscle training -integrated rehabilitation is a feasible, low-cost, and effective approach to enhance early post-operative recovery after cardiac surgery in Pakistan, and should be incorporated into routine physiotherapy practice.