Physio after coronary bypass using a vibration machine

[rabia]

Hi, Please can someone please let me know if a vibrator machine is good after coronary bypass or only manual vibration is good to remove the secretion? And if so how much vibration is required to loosen up the secretion?

Many thanks

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[oscar]

hi pls tell me is vibrator machine is good after coronary bypass or only manual vibration is good to remove the secretion.and how much vibration is required to loosen up the secretion?

Generally NO! Any kind of manual technique such as vibrations or percussion is contraindicated for people post chest surgery- CABG patients usually have a lot of chest pain so anything that can cause more pain or even split the wound in two should really be avoided.

For thick secretions go another route such as IPPB or manual hyperinflation (if the patient is intubated) or even suction...but before that try mobilising, saline nebs, humidified oxygen and ACBT. I suggest you have a read of texts such as Alexandra Hough (Cardiorespiratory Physiotherapy) or Pryor (Physiotherapy for cardiac and respitatory problems) which both have excellent sections on cardiac surgery

[hasanj]

Hi ,mechanical vibration after CABG (coronary artery bypass graft) is useful, some say it's contraindicated other say the opposite.
We used to use vibration with all our patients after surgery and all patients like it. After my long experience with heart patients 99% love vibrations with the vibrator, especially on shoulder (over lung) ,for hard secretions we use:

• humidification with saline (ultrasonic nebulizer)
• exhale exercises
• vibration with vibrator

And advise patient to drink hot drink (e.g. herbal tea) - that's for ex-tub Patients. There are other ways that depend on patients conditions.

[physiobob]

Interesting discussion. I remember back to grad school where I think I was told percussion was contraindicated in the post CABG patient. I also tend to feel vibration was as well but am not sure of any literature that supports the claim that it is in fact dangerous? If anyone can find such a study or can point us to a link where we can read about the negative results of vibration methods as a treatment method in the post CABG patient then this would be very useful. Then again maybe it is time to reconsider our position on this method of treatment, perhaps specifically in relation to the surgical method and tools used to secure the graft - i.e. modern methods and tools vs. old techniques and tools.

[hasanj]

Hi ,you can see cardiopulmonary physical therapy (second edition) also anthor book but in German(Atem Therapy) respiratory therapy.

[sdkashif]

Percussion is used only after 48 hours when the secretions are very tenacious. So it is not used in the first 48 hours. Vibrations and shakings both can be used right after the cardiac surgery CABG along with other procedures like manual hyperinflation and modified postural drainage positionings (lying, half lying, alternate side lying) assisting in removal of secretions and suction manuever. These procedures are used in ICU during the IPPV while patient is on ventilator. When the ventilator is detached and patient is spontaneously breathing, the breathing exercises like ACBT, coughing and huffing and positioning in aiding the drainage and removal of secretions are useful.

References:

Cash's Texbook of Chest, heart and vascular disorders for Physiotherapist, 4th edition By Patricia A.Downie

Physiotherapy for respiratory and cardiac problems by Barbara A.Weber & Jenifer A.Pryor

Tidy's Physiotherapy, 12th edition by Ann Thomson, Alison Skinner & Joan Piercy

[bardu28]

ACBT,autogenic drainage are better...

[fire_ice]

comparing mechanical with manual vibration there is not much difference as show with number of research articles......but considering vibrations as contraindications following is CABG is not acceptable it is only contraindicated if there is a complication following CABG and the patient is on IABP machine.....

[bardu28]

I dont recommend any vibration or percussion after...I recommend ACBT and assistive Autogenic drainage which physiotherapist support chest to decrease pain on chest or breathing..

regards

[hasanj]

hi, using mechanical vibration has evidence ,by its effect on expectoration.

[bardu28]

yes mechanical vibration has effect on expectoration but it is more usefull on Cystic fibrosis, bronchectasis or any other lung diseases which have less problem when u apply mechanical vibration.
so we prefer using other physiotherapy technics which are not uncomfortable to patients.

regards

[Canuck Physio]

Vibrational training will indeed have some interesting applications, however, I suspect that will be in specific populations. For the normal healthy individual, perhaps less so. Please post results here, as case studies can be quite revealing.

Here are some references:
Scan J Med Sci & Sports 17: 12-17, 2007
Medicine & Science in Sports & Exercise ; 38; 1317-1328, 2006.

The findings of a report published in a recent issue of the Journal of Strength & Conditioning Research (18;777, 2004), has shown that performing squats on a vibrating platform provided better improvements in the vertical jump test (a good indication of explosive power). Another study published in the same journal demonstrated that bodybuilders who performed dumbbell curls while standing on the vibrating platform recruited more fast-twitch muscle fibers.

As far as the theory goes, the platform emits high frequency vibrations that “shake” your muscles. This triggers stretch reflexes in muscle fibers that initiate more contractions within the myofiber network. Therefore, performing some exercises on the platform in combination with regular training may provide better gains that standard training alone.

~ Will need to stay on the look out for specific rehabilitative applications of Vibration Training. Thanks for the contributions.

[fire_ice]

Vibrational training may be having affects but how come it proves that it is good for lung clearance , it sounds very illogical .