{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:22:39Z","timestamp":1787502159629,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiotherapy Res Intl"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>This study investigated the effects of combining incentive spirometry with cardiac rehabilitation compared with cardiac rehabilitation alone on postoperative pulmonary complications, clinical\u2010functional recovery, and hospital length of stay in patients undergoing cardiac surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Randomized controlled trial was conducted from May 2019 to October 2023 in two hospitals, including 46 inpatients undergoing cardiac surgery. Participants were assigned to incentive spirometry plus cardiac rehabilitation or cardiac rehabilitation alone. Both interventions were performed twice daily; spirometry used a volume\u2010oriented device, and rehabilitation followed a seven\u2010step protocol (2\u20134 METs). Outcomes included postoperative pulmonary complications, functional capacity (6\u2010min walk test), handgrip strength, respiratory muscle function, and length of hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The incentive spirometry associated with cardiac rehabilitation group had a longer extracorporeal circulation time (98\u00a0\u00b1\u00a026\u00a0min) than the cardiac rehabilitation group (76\u00a0\u00b1\u00a01;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.008). Both groups showed a postoperative decline in respiratory muscle strength, and walking distance (MD: \u221264.37\u00a0m; 95% CI: [\u221224.1; \u2212104.6];\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0=\u00a00.71), with no difference in postoperative pulmonary complications and handgrip strength. The incentive spirometry associated with cardiac rehabilitation group did not significantly differ on postoperative hospital stay compared with the cardiac rehabilitation group (MD: \u22121\u00a0day; 95% CI: [\u22124.71; 2.71];\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0=\u00a0\u22120.19).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this study, no additional benefit was observed with the addition of incentive spirometry to cardiac rehabilitation compared with cardiac rehabilitation alone. No significant differences were detected between groups in postoperative pulmonary complications, hospital length of stay, or clinical\u2010functional recovery among individuals undergoing cardiac surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>Brazilian Registry of Clinical Trials (REBEC) under the number RBR\u20108tsjf97<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pri.70325","type":"journal-article","created":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:24:07Z","timestamp":1787498647000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Adding Incentive Spirometry to Hospital\u2010Based Cardiovascular Rehabilitation on Pulmonary Complications, Hospital Length of Stay, and Clinical\u2010Functional Recovery After Cardiac Surgery: A Randomized Controlled Trial"],"prefix":"10.1002","volume":"31","author":[{"given":"Bruna Elise da Silva","family":"Messias","sequence":"first","affiliation":[{"name":"Graduate Program in Human Communication Disorders Federal University of Santa Maria\u2010UFSM  Santa Maria Rio Grande do Sul Brazil"},{"name":"Physiology and Rehabilitation Laboratory, Federal University of Santa Maria\u2010UFSM  Santa Maria Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3477-6215","authenticated-orcid":false,"given":"Thamires Alessandra Silveira da","family":"Silva","sequence":"additional","affiliation":[{"name":"Graduate Program in Human Communication Disorders Federal University of Santa Maria\u2010UFSM  Santa Maria Rio Grande do Sul Brazil"},{"name":"Physiology and Rehabilitation Laboratory, Federal University of Santa Maria\u2010UFSM  Santa Maria Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6644-1269","authenticated-orcid":false,"given":"Rafaela Anversa","family":"Schreiner","sequence":"additional","affiliation":[{"name":"Physiology and Rehabilitation Laboratory, Federal University of Santa Maria\u2010UFSM  Santa Maria Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Let\u00edcia","family":"Torres","sequence":"additional","affiliation":[{"name":"Institute of Cardiology of Porto Alegre\u2010University Foundation of Cardiology (IC\/FUC)  Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9ssica","family":"Bischoff","sequence":"additional","affiliation":[{"name":"Institute of Cardiology of Porto Alegre\u2010University Foundation of Cardiology (IC\/FUC)  Porto Alegre Rio Grande do Sul 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