Acute changes in handgrip strength, lung function and health-related quality of life following cardiac surgery

Nnamdi Mgbemena; Anne Jones; Pankaj Saxena; Nicholas Ang; Siva Senthuran; Anthony Leicht

doi:10.1371/journal.pone.0263683

Acute changes in handgrip strength, lung function and health-related quality of life following cardiac surgery

PLoS One. 2022 Feb 23;17(2):e0263683. doi: 10.1371/journal.pone.0263683. eCollection 2022.

Authors

Nnamdi Mgbemena^{1

2}, Anne Jones^{1

2}, Pankaj Saxena^{3

4}, Nicholas Ang³, Siva Senthuran⁵, Anthony Leicht^{2

6}

Affiliations

¹ Department of Physiotherapy, James Cook University, Townsville, Queensland, Australia.
² Australian Institute of Tropical Health & Medicine, James Cook University, Townsville, Queensland, Australia.
³ Department of Cardiothoracic Surgery, Townsville University Hospital, Townsville, Queensland, Australia.
⁴ Department of Surgery, James Cook University, Townsville, Queensland, Australia.
⁵ Department of Intensive Care Medicine, Townsville University Hospital, Townsville, Queensland, Australia.
⁶ Department of Sports and Exercise Science, James Cook University, Townsville, Queensland, Australia.

Abstract

Background: Handgrip strength (HGS), lung function and health-related quality of life (HRQoL) are relevant indicators of future cardiovascular risk and mortality. The impact of cardiac surgery on these predictive variables has been under-explored. The aim of this study was to determine the acute (within hospital) changes in HGS, lung function and HRQoL, and their relationships, in adults undergoing elective cardiac surgery. Further, the study examined the relationship between these variables and the predictors for lung function and HRQoL in these patients.

Methods: The study was a prospective cohort study that involved 101 patients who completed pre-operative (1-2 days before surgery) and physiotherapy discharge (5-7 days after surgery) assessments. Handgrip strength, lung function and HRQoL were assessed using JAMAR dynamometers, Vitalograph-Alpha or EasyOne spirometer, and Short-Form 36 questionnaire, respectively. Changes in these variables and their relationships were analysed using paired t-test and Pearson correlation coefficients, respectively. Prediction of lung function and HRQoL using HGS and other co-variates was conducted using regression analysis.

Results: At the time of physiotherapy discharge, lung function, HGS and the physical component of HRQoL were significantly (<0.001) reduced compared to their pre-operative values. Significant (<0.001) and moderate correlations were identified between HGS and lung function at pre-operation and physiotherapy discharge. Handgrip strength was a significant predictor of lung function pre-operatively but not at physiotherapy discharge. Pre-operative lung function and HRQoL, as well as other variables, were significant predictors of lung function and HRQoL during physiotherapy discharge.

Conclusions: Undergoing cardiac surgery acutely and significantly reduced lung function, HGS and physical component of HRQoL in adults with cardiac disease. Assessment of HGS at physiotherapy discharge may be a poor indicator of operative changes in lung function and HRQoL. Clinicians may consider HGS as an inadequate tool in predicting lung function and HRQoL following cardiac surgery.

Publication types

Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cardiac Surgical Procedures / adverse effects*
Elective Surgical Procedures / adverse effects*
Female
Hand Strength*
Heart Diseases / surgery*
Humans
Lung / physiopathology*
Male
Middle Aged
Patient Discharge
Postoperative Complications / etiology*
Prospective Studies
Quality of Life*
Respiratory Function Tests
Self Report
Treatment Outcome

Grants and funding

The study received an internal grant from the College of Healthcare Sciences, James Cook University (https://www.jcu.edu.au/college-of-healthcare-sciences). The funder had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.