4. Discussion
postoperative pulmonary complications, atelectasis, voluntary muscle contractions, pneumonia
PNEUMONIA, ATELECTASIS, PERIOPERATIVE COMPLICATION, POSTOPERATIVE PNEUMOTHORAX
Our study showed that in the NMES group, compared with the control group, there was a more noticeable increase in the strength of the extensor and flexor forces of the knee joint and the distance of 6MT after a course of prehabilitation in preparation for cardiac surgery. However, we did not reveal the effect of NEMS on unstimulated muscles (handgrip strength). When used alone, NMES is inferior in its effect on muscle strength to conventional training with voluntary muscle contractions [To the best of our knowledge, prior to this work, no attempt had been made to assess the effect of NMES on muscle strength prior to cardiac surgery. Research has primarily focused on the ability of NMES to improve muscle strength in patients after cardiovascular surgery [To date, pre-rehabilitation programs before cardiac surgery have consisted of traditional outpatient physical training. With such programs, the goal was not to affect the muscular status of patients; instead, the main task was to reduce the number of perioperative complications and the results of operations in general. For example, a meta-analysis of eight small studies showed that preoperative physical therapy (including local training of the respiratory muscles) can reduce postoperative pulmonary complications (atelectasis and pneumonia) and the length of hospital stay in patients having elective heart surgery. At the same time, such pre-rehabilitation did not affect the incidence of postoperative pneumothorax, the duration of mechanical ventilation, or mortality from all causes [Now, a study is being carried out with longer preparation for surgery: pre-frailty and frailty patients will train for 6–10 weeks before planned coronary bypass surgery (two sessions per week—aerobics and resistance exercises) [