title: Effects of chest physiotherapy on the respiratory function of postoperative gastroplasty patients.
abstract: BACKGROUND
  Bariatric surgery has become increasingly more recommended for the treatment of morbidly obese individuals for whom it is possible to identify co-morbidities other than alterations in pulmonary function. The objective of this study was to evaluate the effects of conventional chest physiotherapy (CCP) and of conventional physiotherapy associated with transcutaneous electrical diaphragmatic stimulation (CCP+TEDS) on pulmonary function and respiratory muscle strength in patients who have undergone Roux-en-Y gastric bypass.
  
  
  METHODS
  In total, 44 female patients with an average age of 37 +/- 7.3 years and an average body mass index (BMI) of 47.4 +/- 6.5 K/m(2) were selected as candidates for Roux-en-Y gastric bypass laparoscopy. They were evaluated for pulmonary volume and flow using spirometry and maximum respiratory pressure through manovacuometry during the preoperative period and on the fifteenth and thirtieth postoperative days.
  
  
  RESULTS
  No differences were detected between CCP and CCP + TEDS, and both factors contributed to the maintenance of pulmonary flow and volume as well as inhalation muscle strength. Exhalation muscle strength was not maintained in the CCP group at fifteen or thirty days postoperative, but it was maintained in patients treated with conventional chest physiotherapy + transcutaneous electric diaphragmatic stimulation.
  
  
  CONCLUSIONS
  These results suggest that both conventional chest physiotherapy and conventional chest physiotherapy + transcutaneous electric diaphragmatic stimulation prevent the reduction of pulmonary function during the Roux-en-Y gastric bypass postoperative period, and that transcutaneous electric diaphragmatic stimulation also contributes to expiratory muscle strength.
authors.affiliation: Postgraduate program in Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos/SP, Brazil. empforti@unimep.br
authors.forename: Eli
authors.initials: E
authors.lastname: Forti
authors.forename: Daniela
authors.initials: D
authors.lastname: Ike
authors.forename: Marcela
authors.initials: M
authors.lastname: Barbalho-Moulim
authors.forename: Irineu
authors.initials: I
authors.lastname: Rasera
authors.forename: Dirceu
authors.initials: D
authors.lastname: Costa
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003964:Diaphragm / Q000502:physiology; D004599:Electric Stimulation Therapy; D005260:Female; D015390:Gastric Bypass / Q000534:rehabilitation*; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008451:Maximal Voluntary Ventilation / Q000502:physiology; D053580:Muscle Strength / Q000502:physiology*; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery; D026741:Physical Therapy Modalities; D011183:Postoperative Complications / Q000517:prevention & control; D011184:Postoperative Period; D012132:Respiratory Muscles / Q000503:physiopathology*; D013997:Time Factors; D014797:Vital Capacity / Q000502:physiology