Physiotherapeutic intervention in the postoperative period of myocardial revascularization: systematic review

Abstract

INTRODUCTION: Myocardial revascularization surgery is the main treatment for advanced coronary artery disease and has proven to be effective, but its potential for postoperative complications directly interferes in the evolution of patients. To minimize the deleterious effects of the surgery, physiotherapy should be started as soon as possible. OBJECTIVES: To review the knowledge about the physiotherapeutic performance in the postoperative period of myocardial revascularization. MATERIALS AND METHODS: It consisted of a systematic review in the PubMed, SciELO, BHS and PEDro databases through the crossing of the key words myocardial revascularization, physical exercise and rehabilitation. Randomized clinical trials of Portuguese and English origin published between 2014 and 2019 that related the physiotherapeutic performance in the postoperative period of myocardial revascularization were included. Duplicate articles, studies that presented intervention only in the preoperative phase, studies which compared the use of pharmacological methods or other surgical procedures, research intentions, studies that showed inadequacy of the proposed subject and PEDro score below 5 were excluded. RESULTS: 12 studies were included because they met the eligibility criteria. The total sample included 435 adult patients of both sexes aged between 30 and 70 years. They were submitted to aerobic, anaerobic and respiratory exercises, electrotherapy, phototherapy and non-invasive mechanical ventilation. CONCLUSION: The procedures commonly performed by physiotherapy in the postoperative phase of myocardial revascularization include techniques related to respiratory physiotherapy and progressive mobilization. Among the interventions employed, aerobic exercise has been the most evident modality in terms of numbers regarding its benefits.