title: Continuous Positive Airway Pressure During Exercise Improves Walking Time in Patients Undergoing Inpatient Cardiac Rehabilitation After Coronary Artery Bypass Graft Surgery: A RANDOMIZED CONTROLLED TRIAL.
abstract: OBJECTIVE
  Continuous positive airway pressure (CPAP) has been used as an effective support to decrease the negative pulmonary effects of coronary artery bypass graft (CABG) surgery. However, it is unknown whether CPAP can positively influence patients undergoing CABG during exercise. This study evaluated the effectiveness of CPAP on the first day of ambulation after CABG in patients undergoing inpatient cardiac rehabilitation (CR).
  
  
  METHODS
  Fifty-four patients after CABG surgery were randomly assigned to receive either inpatient CR and CPAP (CPG) or standard CR without CPAP (CG). Cardiac rehabilitation included walking and CPAP pressures were set between 10 to 12 cmH2O. Participants were assessed on the first day of walking at rest and during walking. Outcome measures included breathing pattern variables, exercise time in seconds (ETs), dyspnea/leg effort ratings, and peripheral oxygen saturation (SpO2).
  
  
  RESULTS
  Twenty-seven patients (13 CPG vs 14 CG) completed the study. Compared with walking without noninvasive ventilation assistance, CPAP increased ETs by 43.4 seconds (P = .040) during walking, promoted better thoracoabdominal coordination, increased ventilation during walking by 12.5 L/min (P = .001), increased SpO2 values at the end of walking by 2.6% (P = .016), and reduced dyspnea ratings by 1 point (P = .008).
  
  
  CONCLUSIONS
  Continuous positive airway pressure can positively influence exercise tolerance, ventilatory function, and breathing pattern in response to a single bout of exercise after CABG.
authors.affiliation: Cardiopulmonary Physiotherapy Laboratory (Dr Pantoni, Dr Thommazo-Luporini, Dr Mendes, Dr Caruso, Mr Mezzalira, Dr Catai, and Dr Borghi-Silva), Nucleus of Research in Physical Exercise, Federal University of São Carlos, São Carlos, São Paulo, Brazil; Department of Physical Therapy (Dr Arena), College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois; and Irmandade Santa Casa Misericordia Hospital (Dr Amaral-Neto), Araraquara, São Paulo, Brazil.
authors.forename: Camila Bianca Falasco
authors.initials: CB
authors.lastname: Pantoni
authors.forename: Luciana
authors.initials: L
authors.lastname: Di Thommazo-Luporini
authors.forename: Renata Gonçalves
authors.initials: RG
authors.lastname: Mendes
authors.forename: Flávia Cristina Rossi
authors.initials: FC
authors.lastname: Caruso
authors.forename: Daniel
authors.initials: D
authors.lastname: Mezzalira
authors.forename: Ross
authors.initials: R
authors.lastname: Arena
authors.forename: Othon
authors.initials: O
authors.lastname: Amaral-Neto
authors.forename: Aparecida Maria
authors.initials: AM
authors.lastname: Catai
authors.forename: Audrey
authors.initials: A
authors.lastname: Borghi-Silva
mesh_terms: D000368:Aged; D045422:Continuous Positive Airway Pressure; D001026:Coronary Artery Bypass / Q000534:rehabilitation*; D004417:Dyspnea / Q000517:prevention & control; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D012123:Pulmonary Ventilation; D015656:Respiratory Mechanics; D016037:Single-Blind Method; D013997:Time Factors; D016138:Walking / Q000502:physiology*
chemical_list: D010100:Oxygen