A randomised controlled trial for the effect of preoperative physiotherapy in patients with an increased risk for the development of postoperative pulmonary complications after open-heart surgery

ISRCTN ISRCTN17691887
DOI https://doi.org/10.1186/ISRCTN17691887
Secondary identifying numbers ZonMw reference 1310.0004
Submission date
20/12/2005
Registration date
20/12/2005
Last edited
28/10/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Surgery
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Not provided at time of registration

Contact information

Dr H.J. Hulzebos
Scientific

University Medical Center Utrecht
Huispost STR 5.203
P.O. Box 85500
Amsterdam
3508 GA
Netherlands

Phone +31 (0)30 253 8484
Email H.Hulzebos@pmbr.azu.nl

Study information

Study designMulticentre, randomised, single blind, active controlled, factorial group trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Not specified
Study typeTreatment
Scientific titleA randomised controlled trial for the effect of preoperative physiotherapy in patients with an increased risk for the development of postoperative pulmonary complications after open-heart surgery
Study acronymPORT
Study hypothesisPreoperative physiotherapy decreased the incidence of postoperative pulmonary complications (PPCs) after open heart surgery on patients with an increased risk of developing PPCs.
Ethics approval(s)Ethics approval received from the local medical ethics committee
ConditionPostoperative pulmonary complications
InterventionThe preoperative physiotherapy consists of a combination of respiratory exercises involving the costo-diaphragm breathing technique, training of the inspiratory muscles for strength and endurance, and teaching a good technique for coughing and 'forced expiration techniques'. The method, involving a progressive training course, is initiated four weeks before the operation.

The training period and progress of the training are sufficient to improve the strength and endurance of the respiratory musculature (also: accessory respiratory muscles). Neuromuscular changes are especially important to increase the efficiency of breathing by the OHS patient. Exercise periods lasting 20 minutes are conducted once per day seven days each week. The therapy is continued by the patient at home, once per week under the supervision of a physiotherapist and six times per week alone. During the supervised training at the beginning and at the end of the period of application, the heart rate and the blood pressure are measured to determine the cardiovascular stress.

In addition the patient keeps a diary, in which he notes the number of exercise sessions completed per week, the duration of each session, and the subjectively experienced stress. In the diary, space is provided for notes regarding physical complaints and problems that occurred before, during or after the exercises.
Intervention typeProcedure/Surgery
Primary outcome measurePostoperative pulmonary complications (PPCs) are defined as 'any pulmonary abnormality occurring in the postoperative period that produces identifiable diseases or dysfunctions that are clinically significant and adversely affect clinical developments' (Brooks-Brunn, 1995). In this study, PPCs are explicitly classified and treated according to the criteria of Kroenke et. al.
Secondary outcome measuresLength of hospital stay.
Overall study start date24/06/2002
Overall study end date01/10/2006

Eligibility

Participant type(s)Patient
Age groupNot Specified
SexNot Specified
Target number of participants600
Participant inclusion criteria1. Undergo voluntary coronary artery bypass graft (CABG) surgery
2. Have an increased risk of developing a PPC. High risk for the development of PPCs is determined by using the risk model during the preoperative consultation with the anaesthesiologist (6 - 8 weeks before the operation)
3. Understand Dutch language
4. Able to read
5. Capable of passing a spirometer test and a determination of the mouth pressure
6. Prepared to sign a contract of informed consent
Participant exclusion criteria1. Cerebrovascular illnesses
2. Immunosuppressive treatment less than 30 days before the operation (chemotherapy or radiotherapy)
3. Neuromuscular illnesses (among others Guillein Barre, muscular dystrophy, myasthenia gravis)
4. A previous lung operation
5. Cardiovascular instability
6. The presence of aneurisms
7. Lung physiotherapy less than eight weeks before the operation
8. Postoperative cardiac and/or complications involving the central nervous system
Recruitment start date24/06/2002
Recruitment end date01/10/2006

Locations

Countries of recruitment

  • Netherlands

Study participating centre

University Medical Center Utrecht
Amsterdam
3508 GA
Netherlands

Sponsor information

The Netherlands Organisation for Health Research and Development (ZonMw) (Netherlands)
Research organisation

P.O. Box 93245
Den Haag
2509 AE
Netherlands

Phone +31 (0)70 349 5111
Email info@zonmw.nl
Website http://www.zonmw.nl
ROR logo "ROR" https://ror.org/01yaj9a77

Funders

Funder type

University/education

University Medical Center Utrecht (UMCU) (The Netherlands)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing planNot provided at time of registration

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 18/10/2006 Yes No
Results article 10/11/2007 Yes No
Results article Secondary analysis 16/04/2016 28/10/2022 Yes No

Editorial Notes

28/10/2022: Publication reference added.