Efficacy of inspiratory muscle training compared to incentive spirometry in preoperative protocol for bariatric surgery

Preoperative exercises can be a strategy for prevention postoperative physiological changes experienced by patients undergoing bariatric surgery. <bold>Objectives:</bold> To assess preoperatively the effectiveness of inspiratory muscle training (IMT) in relation to incentive spirometry(IS) on respiratory strength, cough and pulmonary complications. <bold>Methods:</bold> All of patients were underwent preoperative evaluation for respiratory strength (manovacuometry) and cough peak flow (CPF) and lung reexpansion and upper limb exercises, treadmill or ergometric bicycle for 20 minutes. Between sessions, they received home guidance: IS for control group(CG) and IMT(Powerbreathe®) for interventional group (IG). They were reevaluated in 10th preoperative session,1st and 30th PO. The difference between groups were tested by mixed linear models and Anova two way. <bold>Results:</bold> Among 76 patients, 80% were women with 35 years in average. After intervention, CPF (CG) increased from 86 to 97% and 88 to 99% pred., CG and IG respectively and in the 1st PO decreased (76.2% and 78.6%, CG and IG respectively). MIP was 30% and 41% higher in CG and IG, respectively, and MEP 30% and 10% higher in CG and IG. MIP and MEP decreased in the 1st PO, although remained around 80%pred. On the 30th PO, the baseline preoperative values of MIP, MEP and CPF were recovered, with higher values in the IG. <bold>Conclusion:</bold> Add inspiratory muscle training to patients with obesity submitted to a preoperative protocol with aerobic training and breathing exercises did not promote gains in respiratory muscle strength and cough capacity when compared who received, in addition, incentive spirometry.