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Post Coronary Artery Bypass GraftingNCT06673953

Effect of Respiratory Trainer on Cardiopulmonary Functions in Patients with Upper Cross Syndrome Post-Cardiac Surgery

A study testing Respiratory Muscle Training by (The Breather) and Traditional physical therapy program in people with Post Coronary Artery Bypass Grafting and Post-Cardiac Surgery Patients, run by Cairo University at 1 site in Egypt.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The purpose of this study is to investigate if there is any effect of the respiratory training on cardiopulmonary functions in patients with upper cross syndrome post-cardiac surgery. Read more about this study

Who is it for?
Ages 45 to 55 years, men only
What is being tested?
Respiratory Muscle Training by (The Breather) and Traditional physical therapy program
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
1 siteEgypt
Study dates
28 Aug 2024to 25 Feb 2025
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 45 to 55 years
  • Men only
  • No healthy volunteers
  • Adult

Who may be able to join

  • Sixty post-CABG-male-patients for at least three months and their age ranges from 45 to 55 years old.
  • Craniovertebral angle < 51°, but not less than 30°.
  • Non-specific chronic neck pain: defined as neck pain without an identifiable pathological cause and attributed to poor posture without radiation to upper limbs.
  • VAS score between 3-7.
  • Their body mass index ranges from (25 -29.9) kg/m2.
  • Values of FEV1 and FVC lower than 80%

Who cannot join

  • Rheumatoid arthritis, cervical disc pathology, and traumatic neck pain.
  • History of respiratory disease and clinical signs of severe cardiac events.
  • Neurological disorders which affect the diaphragm.
  • Patients whose BMI is less than 25, or greater than 30 kg/m2.
  • Smokers.
  • Values of FEV1 and FVC higher than 80%
  • Patients with chronic obstructive pulmonary disease or asthma.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Egypt1 site, 1 recruiting
  • Faculty of Physical Therapy, Cairo University

    Giza, Giza Governorate, 11432

    Faculty of Physical Therapy, Cairo University, 02 37617691, Info@pt.cu.edu.eg

    Recruiting

Other trials in Egypt

About this study

The purpose of this study is to investigate if there is any effect of the respiratory training on cardiopulmonary functions in patients with upper cross syndrome post-cardiac surgery.

Hypothesis:

Null hypothesis: There is no effect of the respiratory training on pulmonary functions in patients with upper cross syndrome post-cardiac surgery.

Read the detailed description

Sixty post-CABG-male-patients (n=60) with upper cross syndrome, their age ranges from 45 to 55 years old, are selected from Elbank-Elahly hospital (out-patient clinic), Cairo, Egypt. This randomized control study is performed after assessing and randomly assigning patients, (through using a computer program which generates random numbers), into two equal groups (30 patients for each group).

Respiratory training (study) group. Thirty patients (n=30) will receive respiratory muscles training and traditional physical therapy program for six weeks (three sessions/ week) for 40-60 minutes.

Traditional (control) group. Thirty patients (n=30) will receive the traditional physical therapy program for six weeks (three sessions/ week) for 40-60 minutes.

All subjects enrolled in the study are informed about the aim, technique, and experimental protocol of this study before participation. A written informed consent is assigned before participation.

After open-heart surgeries, patients with median sternotomy must restrict upper limbs movements that stretch the sternum, for 8 to 12 weeks after surgery, and avoid raising their arms above the head.

In addition, inappropriate posture such as forward head posture caused by the incision leads to upper cross syndrome. This causes an inability to perform activities of daily living, and chronic neck pain which adversely affects the respiratory system due to respiratory muscle imbalance.

Chronic neck pain (CNP), due to upper cross syndrome, is one of the most prevalent and costly musculoskeletal complaints associated with significant functional disability.

Equipment:

  1. Evaluative equipment:
  2. Weight and height scales: To measure body weight and height to calculate BMI.
  3. Visual Analog Scale (VAS): To assess pain severity.
  4. Pressure biofeedback instrument: To measure endurance of deep cervical flexors (DCF).
  5. Electronic Spirometer: Digital-CONTEC-SP10-Spirometer-Lung-Breathing-Diagnostic-Vitalograph-Spirometry-Model CMS501 (Made in China), to measure ventilatory function test parameters. Forced expiratory volume in the first second (FEV1), Forced vital capacity (FVC), FEV1/FVC ratio. and Peak expiratory flow rate (PEFR).
  6. Pittsburgh Sleep Quality Index. To measure sleep quality (Arabic version)
  7. pulse oximetry. To measure HR, and SPO2 (Pulse Oximeter GRANZIA Model No: AS-304).
  8. Sphygmomanometer: To measure ABP (Model Number: GT001-110/111 aneroid sphygmomanometer, Zhejiang, China)
  9. Stopwatch. To measure six-minute walk test time.
  10. Short Form 36 (SF-36) Health Survey Questionnaire: To measure quality of life.
  11. Treatment equipment:
  12. Respiratory muscle trainer device (The Breather device).
  13. DCF muscles training device: Pressure biofeedback (Stabilizer TM, Chattanooga Group, Inc., Chattanooga, TN)
  14. Gymna electrotherapy device.
  15. EME ultrasound-therapy device.
  16. A 650-W infrared halogen lamp (Philips Electronics Industries)

Procedure:

  1. Evaluation Procedures: All patients will follow the same evaluative procedures before (baseline) and after 12 weeks of treatment. (illustrated in the Outcome Measures section)
  2. Therapeutic procedures:

Respiratory training (study) group: Patients will receive:

  1. Respiratory muscles training: They will be asked to perform respiratory training through The Breather device beginning with the easiest setting. They will be instructed to inhale deeply and forcefully (at non fatigable resistance) for 2-3 seconds, slight pause, and then exhale forcefully for 2-3 seconds for 10 repetitions with 2 sets.
  2. Traditional physical therapy program in the form of:
  • TENS: Conventional TENS will be applied at high frequency (from 50 Hz to 130 Hz), low intensity (comfortable, not painful) and small pulse duration (50 μs to 200 μs). By applying small surface electrodes on the neck paraspinal muscles for 20 minutes.
  • Low-intensity continuous ultrasonic waves will be applied on the neck paraspinal muscles (trigger points of the trapezius muscles) for 10 minutes.
  • Infrared radiation application will be used for 10 minutes: The lamp should cover the area over the upper back and neck regions.
  • Cervical Stabilization exercise will be performed after three repetitions of stretching exercises for neck muscles as warm-up and cool-down exercises. Then, the exercise will be executed in supine position; the cuff will be put suboccipital. They will reach a 5mm Hg pressure target with increments of 2 mm Hg from a baseline of 20mm Hg to the ultimate level of 30mm Hg with hold for 10 seconds. The duration of contraction will gradually increase up to 10 seconds for each target level. Subjects will perform ten repetitions before progressing to the next target level.

Traditional (control) group: Patients will receive the traditional physical therapy program.

Being tested
Respiratory Muscle Training by (The Breather), Traditional physical therapy program
Keywords
Post-CABG / Upper Cross Syndrome / Respiratory Muscle Training
Medical subject headings
Oculocerebral hypopigmentation syndrome type Preus

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Respiratory Muscle Training by (The Breather)Other

    Also called Respiratory Muscle Training

    Patients are instructed to inhale deeply and forcefully (at non fatigable resistance) for 2-3 seconds, slight pause, and then exhale forcefully for 2-3 seconds for 10 repetitions with 2 sets.

  • Traditional physical therapy programOther

    Also called Conventional physical therapy program

    Traditional physical therapy program in form of: (TENS / Low-intensity continuous ultrasonic / Infrared radiation application / Cervical Stabilization exercise )

Study groups in NCT06673953
Study groupRoleWhat they receive
Respiratory training (study) group.ExperimentalThirty patients (n=30) receiving respiratory muscles training and traditional physical therapy program for six weeks (three sessions/ week) for 40-60 minutes.
Receives: Other: Respiratory Muscle Training by (The Breather); Other: Traditional physical therapy program
Traditional (control) groupActive comparatorThirty patients (n=30) receiving the traditional physical therapy program for six weeks (three sessions/ week) for 40-60 minutes.
Receives: Other: Traditional physical therapy program

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pulmonary functions:

    Measurements of ventilatory function are recorded before and after receiving the treatment sessions (FEV1, FVC, FEV1/FVC, MVV).

    Assessing respiratory improvement.

    Unit of Measure: Liters (L)

    Measured: Baseline (assessment), and at 12 weeks post-intervention.

  2. Six-Minute-Walk Test

    Patients are asked to walk for 6 minutes along a flat corridor. Measured in meters, assessing exercise capacity and functional improvement.

    The SpO2 and heart rate are measured continuously during testing.

    Heart Rate (HR): Measured in beats per minute (BPM), evaluating cardiovascular response.

    SpO2 (Peripheral Oxygen Saturation): Assessing: Blood oxygen saturation levels to evaluate respiratory and cardiovascular efficiency. Unit of Measure: Percentage (%)

    Measured: Baseline (assessment), and at 12 weeks post-intervention.

  3. VO2 max (Maximal Oxygen Consumption)

    Assessing: Maximum oxygen uptake during high-intensity exercise to evaluate aerobic capacity and cardiopulmonary function.

    Estimated based on an equation which contains:

    weight is body weight (kg), 6MWD is distance walked in 6 min (m), age (years), BMI is calculated body mass index(kg/m2), height is body height (cm) and HR is heart rate at the end of the walking test.

    Unit of Measure: mL/kg/min

    Measured: Baseline (assessment), and at 12 weeks post-intervention.

  4. Pittsburgh Sleep Quality Index.

    Respondents are asked to indicate how frequently they have experienced certain sleep difficulties and rate them. Scores for each question range from 0 to 3, with higher scores indicating more acute sleep disturbances.

    Measured: Baseline (assessment), and at 12 weeks post-intervention.

  5. Short Form 36 (SF-36) Health Survey Questionnaire (Arabic version).

    A 36-item scale measures eight domains of health status. The scores are transformed to range from zero where the respondent has the worst possible health to 100 where the respondent is in the best possible health.

    Measured: Baseline (assessment), and at 12 weeks post-intervention.

  6. Pain severity

    Assessing intensity of perceived pain for monitoring changes in pain severity throughout the intervention. Pain severity is assessed by the self-reported Visual Analog Scale (VAS). By using a 10 cm line where patients mark their pain level, with 0 representing "no pain" and 10 representing "worst imaginable pain." Unit of Measure: Points on a 0-10 scale

    Measured: Baseline (assessment), and at 12 weeks post-intervention.

  7. Endurance of DCF

    Endurance of DCF muscles is measured by a pressure biofeedback instrument. The patient lays in the crook lying position and the pressure biofeedback instrument is placed under the neutral cervical spine below the occiput and inflated up to 20 mmHg. The subjects perform this movement at 5 different pressure levels, i.e., 22, 24, 26, 28, and 30 mmHg. Each level is supposed to be held for 10 sec, and the test terminated if they are unable to hold the position for 10 sec at any level or if the maximum level is achieved (30 mmHg).

    Measured: Baseline (assessment), and at 12 weeks post-intervention.

  8. Craniovertebral angle measurement

    Adhesive markers are placed on the tragus of the right ear and the C7 spinous process, and the subjects are instructed to stand by side (lateral view) and to look at a target in front of them with both arms beside the body. Then, a digital camera is fixed at the level of the 7th cervical vertebra. Finally, the Surgi map Spine software is used to analyze the digitalized photographs and measure CVA. It is the angle between 2 imaginary lines: the horizontal line passing through the spinous process of C7 and the line passing from C7 to the tragus of the ear.

    Measured: Baseline (assessment), and at 12 weeks post-intervention.

  9. Weight and height measurement

    Weight and height are recorded, and BMI will be calculated according to the formula: BMI = Weight (Kg) / Height (m2)

    Measured: Baseline (assessment)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Nov 2024
  2. Study start28 Aug 2024
  3. Primary completion20 Jan 2025 (estimated)
  4. Study completion25 Feb 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06673953
Sponsor's protocol ID
P.T.REC/012/005197
Status last verified
Nov 2024
First submitted
1 Nov 2024
Last updated
5 Nov 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Respiratory Muscle Training by (The Breather) and Traditional physical therapy program in people with Post Coronary Artery Bypass Grafting and Post-Cardiac Surgery Patients, run by Cairo University at 1 site in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 5 Nov 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Mostafa Ali (+201004580951, mostafaaly.atia@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pulmonary functions: (time frame: Baseline (assessment), and at 12 weeks post-intervention.). The study lists 9 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Nov 2024.

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