Study of Breathing Muscle Training Before Total Joint or Lower Extremity Surgery to Improve Lung Function and Reduce Complications

What this Trial Is About

Researchers are evaluating the effects of respiratory strengthening exercises on breathing function in adults undergoing total joint arthroplasty or lower extremity orthopedic surgery. The study aims to determine if exercising the breathing muscles before surgery can strengthen them and improve recovery, as breathing function typically decreases for a few days after surgery. This is a randomized, prospective pilot study focused on reducing post-operative pulmonary complications in shorter surgeries with expected brief hospital stays. Participants will be randomly assigned to one of three groups daily inspiratory muscle training dIMT for 2-4 weeks prior to surgery, a single acute inspiratory muscle training session aIMT immediately before surgery, or usual surgical standard of care SOC. The training uses a pressure threshold device that provides resistance during inspiration. The dIMT group completes daily sessions of 5 sets of 5 maximal breaths at 70% of maximal inspiratory pressure MIP, while the aIMT group completes one similar session guided by a physical therapist within 30 minutes before anesthesia. The SOC group receives standard care without training. Participants will be evaluated about 4 weeks before surgery, in pre-operative holding, and during the first 24 hours post-surgery. Measurements include inspiratory muscle strength and lung function tests such as maximal inspiratory pressure and forced vital capacity. Researchers will also monitor post-operative pulmonary complications up to 10 days after surgery. Participants will keep logs to track exercise compliance, and the study will assess the impact of training on breathing function decline and clinical outcomes following surgery.

Pre-operative Inspiratory Muscle Strength Training in Total Joint Surgery