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Acute Hemodynamic Response to Acapella in Phase 1 Cardiac Rehabilitation Following Coronary Artery Bypass Graft Surgery

Fozia , Fozia , Jamal Ali Moiz , Divya M. Shama , M. Ejaz Hussain

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Physiotherapy and Occupational Therapy Journal 6(2):p 65-73, April - June 2013. | DOI:

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Abstract

Purpose:The purpose of this study was to evaluate the acute hemodynamic response to Acapella in patients underwent coronary artery bypass graft surgery (CABG). Methods: Fifteen (n=15, mean age: 57.6+9.8 years) post CABG patients were selected for this study from cardiothoracic unit of Safdarjung Hospital, New Delhi. All patients used Acapella during their phase 1 cardiac rehabilitation program. They were asked to breath from diaphragm taking in a larger than normal breath, hold breath for 2 to 3 seconds and exhale actively but not forcefully, through the device, exhalation lasted approximately 3 to 4 times longer than inhalation. It was performed 10 to 20 PEP breaths. Patients were instructed to remove the mouthpiece and perform 2 to 3 ‘huffs’ coughs to raise secretions as needed. These procedures had been repeated 3 to 4 times. Measurements of systolic blood pressure, diastolic blood pressure heart rate, rate pressure product, arterial oxygen saturation and respiratory rate were taken before, during, immediately after and 30 minutes after using Acapella. Rate of perceived exertion and sputum amount were taken after using Acapella. Data were analysed by SPSS (20) by comparing the means of outcomes, using repeated measure ANOVA. Results: As a result of use of Acapella during cardiac rehabilitation, a significant improvement was observed in the sputum volume mean (7.7 ml), respiratory rate (p<0.001) and SPO2 (p<0.001). Acapella caused no significant hemodynamic response such as systolic blood pressure (p=0.239), diastolic blood pressure (p=0.360), heart rate (p=0.60) and rate pressure product. Conclusion: Use of Acapella during phase 1 cardiac rehabilitation seems to be safe, without alteration on hemodynamic variables; in addition, it seems an effective adjunct for the removal of bronchial secretions in patients underwent coronary artery bypass surgery. 

Keywords: Acapella; hemodynamic; cardiac rehabilitation; Coronary artery bypass graft. 

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