title: Effects of inspiratory muscle training on muscular and pulmonary function after bariatric surgery in obese patients.
abstract: BACKGROUND
  This study seeks to assess the effect of inspiratory muscle training (IMT) on pulmonary function, respiratory muscle strength, and endurance in morbidly obese patients submitted to bariatric surgery.
  
  
  METHODS
  Thirty patients were randomly assigned to sham muscular training, or to IMT with a threshold device (40% of maximum inspiratory pressure, MIP), for 30 min/day, from the 2nd until 30th postoperative (PO) day. All of them were submitted to a standard respiratory kinesiotherapy and early deambulation protocol. Data on spirometry, maximum static respiratory pressures, and respiratory muscle endurance were collected on the PO days 2, 7, 14, and 30 in a blinded matter.
  
  
  RESULTS
  IMT enabled increases in PO MIP and endurance, and an earlier recovery of the spirometry parameters FEV(1), PEF, and FEF(25-75%). Comparing to preoperative values, MIP was increased by 13% at the 30th PO day in the trained group, whereas control group had a reduction of 8%, with higher values for the IMT group (30th PO, IMT-130.6 ± 22.9 cmH(2)O; controls-112.9 ± 25.1 cmH(2)O; p < 0.05). Muscular endurance at the 30th PO day was increased in the trained group comparing to preoperative value (61.5 ± 39.6 s vs 114.9 ± 55.2 s; p < 0.05), a finding not observed in the control group (81.7 ± 44.3 vs 95.2 ± 42.0 s).
  
  
  CONCLUSIONS
  IMT improves inspiratory muscle strength and endurance and accounts for an earlier recovery of pulmonary airflows in morbidly obese patients submitted to bariatric surgery.
authors.affiliation: Course of Physiotherapy, University of Itauna, Itauna, Brazil.
authors.forename: Carla Cristine Cunha
authors.initials: CC
authors.lastname: Casali
authors.forename: Ana Paula Manfio
authors.initials: AP
authors.lastname: Pereira
authors.forename: José Antônio Baddini
authors.initials: JA
authors.lastname: Martinez
authors.forename: Hugo Celso Dutra
authors.initials: HC
authors.lastname: de Souza
authors.forename: Ada Clarice
authors.initials: AC
authors.lastname: Gastaldi
mesh_terms: D000328:Adult; D001945:Breathing Exercises; D005260:Female; D015390:Gastric Bypass; D015391:Gastroplasty; D006801:Humans; D008171:Lung Diseases / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D010807:Physical Endurance; D011183:Postoperative Complications / Q000517:prevention & control*; D012123:Pulmonary Ventilation; D020127:Recovery of Function; D013147:Spirometry