OBJECTIVE: To compare the effects of conventional respiratory physical therapy (CRP) and CRP associated with transcutaneous electrical diaphragmatic stimulation (TEDS) on the pulmonary volumes and the thoracoabdominal mobility of patients undergoing bariatric surgery. METHODS: This randomized prospective study evaluated 44 female candidates for bariatric surgery (age 37.4±8.1 years; body mass index 47.4±6.1 kg/m²), before surgery and 15 and 30 days after surgery. The candidates were evaluated with regard to measurements of inspiratory reserve volume (IRV), expiratory reserve volume (ERV), inspiratory capacity (IC) and thoracoabdominal mobility, by means of spirometry and cirtometry, respectively. CRP consisted of diaphragmatic respiratory exercises, deep fractionated inspiration and respiratory exercises associated with upper limb movement. One set of 10 repetitions of each exercise was carried out twice daily while hospitalized. For TEDS, two electrodes were placed on the parasternal region, next to the xiphoid process, and another two between the sixth and seventh intercostal spaces, bilaterally on the anterior axillary lines. Friedman's test was used to compare repeated measures within groups, and the Mann-Whitney test for comparisons between groups. P values <0.05 were taken to be statistically significant. RESULTS: The IRV, ERV and thoracoabdominal mobility measurements increased significantly in the CRP+TEDS group. In contrast, the IC measurements decreased significantly both in the CRP and in the CRP+TEDS groups. CONCLUSION: The obese women who underwent bariatric surgery and received postoperative CRP+TEDS presented greater gains in some of the pulmonary volumes and improvements in the amplitude of respiratory movements.
physical therapy; electrical stimulation; bariatric surgery; morbid obesity; cirtometry; spirometry
