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Postoperative outcomes following preoperative inspiratory muscle training in patients undergoing open cardiothoracic or upper abdominal surgery: protocol for a systematic review

Christina M Mans1, Julie C Reeve2*, Catherine A Gasparini3 and Mark R Elkins4

Author Affiliations

1 Physiotherapy Department, Waikato Hospital, Waikato District Health Board, Hamilton, New Zealand

2 Division of Rehabilitation and Occupation Studies, Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand

3 Disability Service, Student Support Services, University of Western Sydney, Sydney, Australia

4 Centre for Evidence-Based Physiotherapy, The George Institute for Global Health, Sydney, Australia

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Systematic Reviews 2012, 1:63  doi:10.1186/2046-4053-1-63

Published: 18 December 2012



In patients undergoing open cardiothoracic and upper abdominal surgery, postoperative pulmonary complications remain an important cause of postoperative morbidity and mortality, impacting upon hospital length of stay and health care resources. Adequate preoperative respiratory muscle strength may help protect against the development of postoperative pulmonary complications and therefore preoperative inspiratory muscle training has been suggested to be of potential value in improving postoperative outcomes.


A systematic search of electronic databases will be undertaken to identify randomized trials of preoperative inspiratory muscle training in patients undergoing elective open cardiothoracic and upper abdominal surgery. From these trials, we will extract available data for a list of predefined outcomes, including postoperative pulmonary complications, hospital length of stay and respiratory muscle strength. We will meta-analyze comparable results where possible, and report a summary of the available pool of evidence.


This review will provide the most comprehensive answer available to the question of whether preoperative inspiratory muscle training is clinically useful in improving postoperative outcomes in patients undergoing cardiothoracic and upper abdominal surgery. It will help inform clinicians working in the surgical arena of the likely effectiveness of instituting preoperative inspiratory muscle training programs to improve postoperative outcomes.

Inspiratory muscle training; preoperative; postoperative complications