OBJECTIVE: The aim of this study is to identify the postoperative ISIC changes relative to preoperative ISIC after OHS, and determine their predictors, including patient characteristics factors and IS performance parameters such as inspiration volumes (ISv) and frequencies (ISf).
METHODS: This is a prospective study with blinding procedures involving 95 OHS patients, aged 52.8±11.5 years, whose ISIC was measured preoperatively (PreopISIC) until fifth postoperative day (POD), while ISv and ISf monitored with an electronic device from POD1-POD4. Regression models were used to identify predictors of POD1 ISIC, POD2- POD5 ISIC increments, and the odds of attaining PreopISIC by POD5.
RESULTS: The ISIC reduced to 41% on POD1, increasing thereafter to 57%, 75%, 91%, and 106% from POD2-POD5 respectively. Higher PreopISIC (B=-0.01) significantly predicted lower POD1 ISIC, and, together with hyperlipedemia (B=11.52), which significantly predicted higher POD1 ISIC, explained 13% of variance. ISv at relative percentages of PreopISIC from POD1-POD4 (BPOD1=0.60, BPOD2=0.56, BPOD3=0.49, BPOD4=0.50) significantly predicted ISIC of subsequent PODs with variances at 23%, 24%, 17% and 25% respectively, but no association was elicited for ISf. IS performance findings facilitated proposal of a postoperative IS therapy target guideline. Higher ISv (B=0.05) also increased odds of patients recovering to preoperative ISIC on POD5 while higher PreopISIC (B=- 0.002), pain (B=-0.72) and being of Indian race (B=-1.73) decreased its odds.
CONCLUSION: ISv appears integral to IS therapy efficacy after OHS and the proposed therapy targets need further verification through randomized controlled trials.
METHODS: Twenty-four participants, 10 males and 14 females (25 ± 4.0 yr; 160 ± 10 cm; 62 ± 14.5 kg) performed two sessions of submaximal cardiorespiratory exercise at incremental heart rate reserve (HRR) stages ranging from 40 to 85% of HRR: one session was performed with a currently available CTT that was affixed to a wall in front of the participants, and the other session was conducted with a tMTT with a 1-s inter-stimulus interval that was displayed from a tablet. In each session, the participants performed six stages of exercise at 40, 50, 60, 70, 80, and 85% HRR on a treadmill and were also asked to rate their perceived exertion based on Borg's 6 to 20 Rating of Perceived Exertion (RPE) at each exercise stage.
RESULTS: The newly designed tMTT significantly delineated all the six stages of incremental exercise (p ≤ 0.017), while CTT could only delineate exercise stages at 60, 80, and 85% HRR. However, in estimations of exercise intensity, the tMTT demonstrated only moderate associations with HRR and Borg's RPE, similarly to the CTT.
CONCLUSION: If the purpose of exercise monitoring is to detect the intensity of light, moderate, and vigorous exercise intensity, the tMTT could be more universally applicable. However, due to its larger variability of speech rate across exercise intensities, the time-regulated approach may alter the speech breathing characteristics of the exercising individuals in other ways that should be investigated in future research.