Archives of Physical Medicine and Rehabilitation · Jul 4, 2026

The Effectiveness of Perioperative Respiratory Muscle Exercise in Elderly Cardiac Surgery Patients: A Randomized Controlled Trial

By Wang Q, Shao J, Peng Y et al.

OBJECTIVE: This study aimed to evaluate the impact of perioperative respiratory muscle training on respiratory muscle strength, pulmonary function, functional capacity, and prognostic outcomes in patients undergoing surgery. DESIGN: A randomized controlled trial. SETTING(S): Cardiac surgery ward and cardiac surgery intensive care unit of a tertiary Grade A hospital in Fuzhou, China. PARTICIPANTS: Eighty-two participants. INTERVENTIONS: Perioperative respiratory muscle exercise. MAIN OUTCOME MEASURES: Eighty-two patients were randomly assigned to either the intervention group (n=42), who performed perioperative respiratory muscle training, or the control group (n=40). The intervention group completed respiratory muscle exercise from admission to discharge (except during mechanical ventilation). Respiratory muscle strength was assessed upon admission, the day before surgery, on the third day postintensive care unit transfer, and at discharge. Each patient underwent a lung function test, a 6-minute walk test, a self-efficacy for exercise scale, an anxiety and depression test, and a quality of life questionnaire, before and after intervention. RESULTS: Compared to the control group, the intervention group showed significantly greater improvements in maximal inspiratory pressure (57.69±10.85 cmH₂O vs 48.28±10.30 cmH₂O), pulmonary function, functional capacity, postoperative pulmonary complications (38.1% vs 65.0%), inspiratory muscle weakness (42.9% vs 85.0%), duration of mechanical ventilation and intensive care unit stay, level of anxiety and depression, quality of life, and length of postoperative hospitalization. In addition, the incidence of postoperative pulmonary (9.5% vs 22.5%) and rehospitalization within 6 months (9.5% vs 17.5%) was reduced, though not statistically significant. CONCLUSIONS: Perioperative respiratory muscle training could contribute to improved respiratory muscle strength, pulmonary function, functional capacity, prognostic outcomes, and quality of life in elderly cardiac surgery patients. Continuous activation of the respiratory muscles could provide multiple benefits for these individuals.

doi.org/10.1016/j.apmr.2026.06.023PubMed 42401308Interventions