ClinicalTrials.gg
RecruitingNCT06814951Updated Apr 27, 2026

Acute Effect of the Thoraco-abdominal Rebalance Method Postoperative Cardiac Surgery

An interventional study of TAR Method and Conventional physiotherapy in Respiratory Complications, Diaphragmatic Excursion and Pulmonary Spirometry, sponsored by Instituto de Cardiologia do Rio Grande do Sul. Recruiting at 1 site in Brazil. Open to participants aged 35 Years and older. Per ClinicalTrials.gov, last updated 2026-04-27.

Sponsored by Instituto de Cardiologia do Rio Grande do Sul · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Apr 2026, 7 months ago, but the record still lists the study as recruiting.
  • Registered 5 months after the study started (first participant enrolled Sep 2024, registered Feb 2025).
  • Started Sep 2024; still recruiting 2 years 2 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
26
Allocation
Randomized
Ages
35 Years and older
Sex
All
01

Study summary

Introduction: The thoracoabdominal rebalancing (TAR) method aims to promote diaphragmatic juxtaposition, in addition to seeking to increase respiratory muscle strength and adjust muscle tone. However, scientific publications on this method in heart patients undergoing coronary artery bypass grafting (CABG) are still scarce, justifying the need to carry out this study for information, evaluation, diagnosis and treatment purposes in the health area with an emphasis on cardiology.

Objective: To evaluate whether diaphragmatic ultrasound findings differ between the TAR method and conventional physiotherapy in post-CABG patients.

Methods: This is a randomized, single-blind clinical trial. Adults (>35 years), hemodynamically stable, who underwent CABG (\<24 hours) and had a prescription for physiotherapy will be included. Patients will be randomized into two groups: 1) intervention group [IG] - TAR; 2) control group [CG] - standard physiotherapy approach. Interventions will be performed at a single time and the following variables will be collected pre- and post-intervention: heart rate (HR), respiratory rate (RR), peripheral oxygen saturation (SpO2), mean arterial pressure (MAP), diaphragmatic ultrasound (US) to identify possible acute findings in both groups, respiratory distress scale and pulmonary complications scale will be applied at the end of the interventions.

Keywords: Physiotherapy; Cardiology; Ultrasonography

Read the detailed description

To compare the effect of conventional physiotherapy techniques with the management of thoracoabdominal rebalancing in postoperative patients after myocardial revascularization surgery, carefully evaluating these effects through diaphragm ultrasound and pulmonary spirometry, in addition to variables such as vital signs and respiratory distress scales and pulmonary complications after cardiac surgery. This is a randomized trial in which patients undergoing myocardial revascularization surgery at the Cardiology Institute of Rio Grande do Sul will participate.

Individuals over 35 years of age who underwent myocardial revascularization surgery with prescribed physiotherapy treatment will be included in the study. Patients who were intubated and/or remained on mechanical ventilation for more than twelve hours or who required non-invasive mechanical ventilation before or during the collection period will be excluded.

The study was submitted to the Research Ethics Committee of the Cardiology Institute of Porto Alegre (CEP-ICFUC). All study participants will receive clear explanations about the research, and those who voluntarily agree to participate in the study will sign the informed consent form in two copies, one of which will be made available to the participant and the other to the researchers. Participants will not be paid, nor will they receive any assistance during or after the end of the research (466/12).

The benefits of this research will be in improved conduct that prevents or reduces complications and/or respiratory discomfort, as well as speeding up the patient's recovery, aiming for faster hospital discharge. Patients selected for the control group (conventional physiotherapy) will be exposed to respiratory physiotherapy techniques such as vibrocompression, passive manual expiratory therapy, acceleration of expiratory flow, fractional inspiration in times, diaphragmatic breathing and aspiration when necessary, and patients selected for group intervention will undergo thoracoabdominal rebalancing management such as abdominal supports and/or in the ileocostal space, inspiratory assistance, release of the shoulder girdle, thoracic swing, release of the pectoralis major and deltoid muscles together with aspiration if necessary.

The research presents minimal risks for the participants, which are related to the measurement of hemodynamic variables through the monitor, in addition to the pulmonary spirometry test and diaphragmatic analysis through ultrasound, and/or application of conventional physiotherapy techniques such as vibrocompression, acceleration of expiratory flow, passive manual expiratory therapy that may suggest some discomfort or pain when touching the chest in a sensation of pressure and vibration. Patients undergoing thoracoabdominal rebalancing treatment are expected to have lower scores on the pulmonary complications scale, Downes and Raphaelly respiratory distress scale and, consequently, better diaphragmatic excursion, as well as improvements in other variables.

02

Conditions studied

  • Respiratory Complications
  • Diaphragmatic Excursion
  • Pulmonary Spirometry

Keywords

  • Physiotherapy
  • Ultrasonography
  • Cardiology
03

In context

Lead sponsor

Instituto de Cardiologia do Rio Grande do Sul is the lead sponsor of 76 studies on the registry; 9 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
35 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Individuals over 35 years of age who undergo coronary artery bypass graft surgery with prescribed physiotherapy treatment will be included in the study.

Exclusion criteria

Exclusion Criteria:

  • Patients who are intubated and/or have remained on mechanical ventilation for more than twelve hours, or who require non-invasive mechanical ventilation (NIV) before or during the collection period will be excluded.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Sequential assignment
Masking
Single (Participant)
Enrollment
26 participants (estimated)

Study arms

  • Active comparator
    Conventional physiotherapy

    Patients selected for the control group (conventional physiotherapy) will be exposed to respiratory physiotherapy techniques such as vibrocompression, manual passive expiratory therapy, acceleration of expiratory flow, fractional inspiration in times, diaphragmatic breaths and aspiration when necessary.

    Procedure: Conventional physiotherapy

  • Active comparator
    TAR Method

    Patients selected for the intervention group will undergo thoracoabdominal rebalancing treatment, such as abdominal and/or ileocostal space supports, inspiratory assistance, release of the shoulder girdle, thoracic balance, release of the pectoralis major and deltoid muscles, along with aspiration, if necessary.

    Procedure: TAR Method

Interventions

  • ProcedureTAR Method

    Patients selected for the intervention group will undergo thoracoabdominal rebalancing management such as abdominal supports and/or in the ileocostal space, inspiratory assistance, release of the shoulder girdle, thoracic balance, release of the pectoralis major and deltoid muscles together with aspiration if necessary.

  • ProcedureConventional physiotherapy

    Patients selected for the control group (conventional physiotherapy) will be exposed to respiratory physiotherapy techniques such as vibrocompression, manual passive expiratory therapy, acceleration of expiratory flow, fractional inspiration in times, diaphragmatic breaths and aspiration when necessary.

06

What researchers measure

Primary outcomes

  1. Diaphragmatic excursion

    Increase in measures

    Time frame: Immediately before the intervention and within 30 minutes after the intervention

  2. Change in the Downes and Raphaelly respiratory distress scale

    Points 0-10, where 0 is best and 10 is worst

    Time frame: Immediately before the intervention and within 30 minutes after the intervention

  3. Pulmonary spirometry

    Increase in measurements: CVF (L)

    Time frame: Immediately before the intervention and within 30 minutes after the intervention

Secondary outcomes

  1. Respiratory rate

    Breathing intervals per minute

    Time frame: Immediately before the intervention and within 30 minutes after the intervention

  2. Peripheral oxygen saturation

    SpO2

    Time frame: Immediately before the intervention and within 30 minutes after the intervention

  3. Mean arterial pressure

    mmHg

    Time frame: Immediately before the intervention and within 30 minutes after the intervention

  4. Lung auscultation assessment

    Wheezing, rhonchi or stridor

    Time frame: Immediately before the intervention and within 30 minutes after the intervention

  5. Heart rate

    Beats per minute

    Time frame: Immediately before the intervention and within 30 minutes after the intervention

07

Study locations

1 of 1 sites recruiting
  • Intituto de Cardiologia do Rio Grande do Sul
    Porto Alegre, Rio Grande do Sul 90620-001, Brazil
    Recruiting
08

References and documents

Publications

  • SANTANA, Pauliane Vieira et al. Ultrassonografia diafragmática: uma revisão de seus aspectos metodológicos e usos clínicos. Jornal Brasileiro de Pneumologia, v. 46, 2020.
  • Hulzebos EH, Van Meeteren NL, De Bie RA, Dagnelie PC, Helders PJ. Prediction of postoperative pulmonary complications on the basis of preoperative risk factors in patients who had undergone coronary artery bypass graft surgery. Phys Ther. 2003 Jan;83(1):8-16. PubMed 12495408 ↗
  • OLIVEIRA, Miriana Carvalho; SOBRINHO, Cristina Ortiz; ORSINI, Marco. Comparação entre o método Reequilíbrio Toracoabdominal e a fisioterapia respiratória convencional em recém-nascidos com taquipneia transitória: um ensaio clínico randomizado. Fisioterapia Brasil, v. 18, n. 5, p. 598-607, 2018
  • SOARES, Jainy Lima; DE SOUSA, Anderson Moura Bonfim; DA SILVA MEDEIROS, Joelson. Physiotherapy treatment in the pre and postoperative period of cardiac surgery: an integrative review. Revista Ciência & Saberes-Facema, v. 3, n. 3, p. 624-629, 2017.
  • SANTANA, Vilma Maria et al. Health Education for Patients in the Perioperative Period of Cardiovascular Surgery: Experience Report. Brazilian Journal of Health Review, v. 4, n. 2, p. 5559-5571, 2021.
  • 1. BECCARIA, Lucia Marinilza et al. Postoperative complications in patients undergoing cardiac surgery in a teaching hospital. Archives of Health Sciences, v. 22, n. 3, p. 37-41, 2015.

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started Sep 2024 (actual). Primary completion is estimated for Apr 2026, 19 months after the start.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 4, 2025
First posted
Feb 7, 2025
StartActual
Sep 1, 2024
Primary completionEst.
Apr 2026
CompletionEst.
Apr 2026
Last update
Apr 27, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Apr 27, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06814951
Lead sponsor
Instituto de Cardiologia do Rio Grande do Sul
Responsible party
Sponsor
First posted
Feb 7, 2025
Start date
Sep 1, 2024
Primary completion
Apr 2026 (estimated)
Completion
Apr 2026 (estimated)
Last update
Apr 27, 2026

Study contacts

Karolini R Branco
Contact
karolinireis@hotmail.com
+55(051)995075412
Bruna Eibel
Contact
brunaeibel@gmail.com
+55(051)997001110
Instituto de Cardiologia do Rio Grande do Sul
principal investigator · Instituto de Cardiologia do Rio Grande do Sul, Porto Alegre, Brasil

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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