Pre- and postoperative physiotherapy
Am Soc Anesth Task Force (2000) Practice advisory for the prevention of perioperative peripheral neuropathies. Anesthesiology, 92, 1168-82
Arthur et al (2000) Effect of a preoperative intervention on preoperative and postoperative outcomes. Ann Int Med, 133, 253-62
preoperative exercise and education leads to more speedy postop recovery
Ayoub J (2001) Diaphragm movement before and after cholecystectomy. Anesth Analg, 92, 755-61
effects of deep breathing
Banasik (1996) Effect of lateral position on arterial and venous blood gases in postoperative cardiac surgery patients. Am J Crit Care, 5, 121-6
right-side-lying is better than left-side-lying for blood gases after heart surgery
Bandolier (1998) Physiotherapy & surgery. Bandolier, 5, 6 (jr2.ox.ac.uk/Bandolier)
prophylactic physiotherapy reduces postop lung complications
Bardram L (1995) Recovery after laparoscopic colonic surgery with epidural analgesia and early oral nutrition and mobilisation. Lancet, 345, 763-4
rehab + early nutrition leads to discharge 2/7 earlier than controls
Basse L (2000) A clinical pathway to accelerate recovery after colonic resection. Ann Surg, 232, 51-7
post-op rehab reduces hospital stay
Bonde P, Mc Manus K, McAnespie M et al (2002) Lung surgery: identifying the subgroup at risk for sputum retention. Eur J Cardiothorac Surg, 22, 18-22
ejcts.ctsnetjournals.org/cgi/content/abstract/22/1/18?ijkey=c02b3d0ba4f6b365c3e1354ed44a98da8d01368e&keytype2=tf_ipsecsha
pre-operatively, lung surgery patients at risk of sputum retention can be predicted by one of: current smokers, history of COPD, CVA, or ischaemic heart disease, and absence of regional analgesia
Brasher PA, McClelland KH, Denehy L (2003) Does removal of deep breathing exercises from a physiotherapy programme alter patient outcomes? Austr J Physiother, 49, 165-73
breathing exercises appear unnecessary after cardiac surgery
Brooks D, Crowe J, Kelsey CJ et al (2001) A clinical practice guideline on peri-operative cardiorespiratory physical therapy. Physiother Canada, 53, 1, 9-25.
translates evidence into practice
Brooks D et al (2002) Discharge criteria from perioperative physical therapy. Chest, 121, 488-94
discharge scoring tool
Browning L, Denehy L, Scholes RL (2007) The quantity of early upright mobilisation performed following upper abdominal surgery is low: an observational study. Austr J Physiother, 53, 1, 47-52
ajp.physiotherapy.asn.au/AJP/vol_53/1/AustJPhysiotherv53i1Browning.pdf
Brunelli A, Monteverde M, Al Refai M et al (2004) Stair climbing test as a predictor of cardiopulmonary complications after pulmonary lobectomy in the elderly. Ann Thorac Surg, 77, 266-70
ats.ctsnetjournals.org/cgi/content/abstract/77/1/266?ijkey=cfbdae8c03dea7abc18a9f65dad08dd9f0e05519&keytype2=tf_ipsecsha
a symptom-limited stair climbing test accurately predicts cardiopulmonary complications
Brutsche MH (2000) Exercise capacity and extent of resection as predictors of surgical risk in lung cancer. Eur Resp.J, 15, 828-32
Bruton A, Donovan H, Langridge E (2009) The Southampton physiotherapy post-operative screening tool. ACPRC Journal, 41, 9-15
Carmini V, Damignani R, Brooks D (2000) Preoperative physiotherapy teaching in paediatric cardiac patients. Physiother Can, 42, 312-14
preoperative advice on breathing and mobility leads to more rapid recovery
Chumillas S (1998) Prevention of postoperative pulmonary complications through respiratory rehabilitation. Arch Phys Med Rehab, 79, 5-9
combination of physiotherapy techniques reduces postoperative complications
Cockram J, Jenkins S (1999) Cardiovascular and respiratory responses to early ambulation and stair climbing following coronary artery surgery. Physiother Theory Pract, 15, 3-15
postop mobilisation increases lung volumes and V/Q matching + mobilises secretions
Crawford BL (1993) The influence of pre-operative physiotherapy on postoperative FRC following CABG. Physiother Ireland, 14, 1, 11-14. (abstract in Physiotherapy, 78, 736, 1992).
preoperative intervention improves post-op lung volume
Darnall BD (2009) Self-delivered home-based mirror therapy for lower limb phantom pain. Am J Phys Med Rehabil, 88, 78-81
www.amjphysmedrehab.com/pt/re/ajpmr/abstract.00002060-200901000-00011.htm;jsessionid=JTMLMh9MK5C9NmsrGfYNyFXvS2pJkX1bnkG6xMJ91QqQBDt7Q5hZ!-1035908147!181195628!8091!-1
successful self-management of phantom pain
Denehy L et al (2001) A randomized controlled trial comparing periodic mask CPAP with physiotherapy after abdominal surgery. Physiother Res International, 6, 236-50
addition of periodic CPAP to traditional physiotherapy did not affect outcome
Diane J (2007) Exercise, quality of life and symptoms in men and women five to six years after coronary artery bypass graft surgery. Heart Lung, 36, 6, 387-97
regular exercise improves on-going quality of life 5 to 6 years after CABG
Dronkers J (2008) Prevention of pulmonary complications after upper abdominal surgery by preoperative IMT. Clin Rehabil, 22, 134-42
preoperative inspiratory muscle training reduces atelectasis in patients having elective abdominal aortic aneurysm surgery
Durrant V, Moore K (2004) Early mobilisation of post-surgical patients. ACPRC Journal, 36, 32-6
review of the evidence base and application of post-op mobilisation
Ebeo CT et al (2002) The effect of BiPAP on postoperative pulmonary function following gastric surgery for obesity. Respir Med, 96, 672-6
postop BiPAP for obese patients improves lung function but not complication rate
Hall JC et al (1996) Prevention of respiratory complications after abdominal surgery. BMJ, 312, 148-53
the most efficient regimen of prophylaxis against respiratory complications after abdominal surgery is deep breathing for low risk patients and incentive spirometry for high risk
Herring D, King AI, Connelly M (1987) New rehabilitation concepts in management of radical neck dissection syndrome. Phys Ther, 67, 1095-9
comprehensive exercise programme after major head and neck surgery
Hulzebos EHJ, Helders PJM, Favie NJ, et al (2006). Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high-risk patients undergoing CABG surgery: a randomized clinical trial. JAMA, 296, 1851-7
jama.ama-assn.org/cgi/content/full/296/15/1851
inspiratory muscle training in high risk patients can reduce the incidence of post-operative pneumonia and shorten hospitalization
Jarski RW (2000) The effectiveness of osteopathic manipulative treatment following surgery. Alt Therapies, 6, 5, 77-81
stairs done 20% earlier, walking 43% further, less analgesia, shorter hospital stays than control group
Kδrki A et al (2001) Efficacy of physical therapy and exercise after a breast cancer operation. Crit Rev Phys Rehab Med, 13, 159-90
systematic review covering exercises, lymphodoema treatment and rehab
Kawamura H (1999) The effects of pre-and-postoperative contralateral TENS for phantom limb pain in amputees. WCPT Proceedings, p.61
TENS to remaining limb given to sites corresponding to painful sites on amputated limb
Kempainen RR (2001) Evaluation and management of patients with pulmonary disease before thoracic and cardiovascular surgery. Sem Thorac Cardiovasc.Surg, 13, 105-15
Kiser TS (1997) Pulmonary embolism in rehabilitation patients: Relation to time before return to physical therapy after diagnosis of deep vein thrombosis. Arch Phys Med Rehab, 78, 9, 942-5
if a DVT is diagnosed, the affected limb should be immobilised for at least 48 to 72 hours while the patient is being anticoagulated
Kwon O-Y, Jung D-Y, Kim Y et al (2003) Effects of ankle exercise combined with deep breathing on blood flow velocity in the femoral vein. Austr J Physiother, 49, 253-8
combination of deep breathing and ankle exercises increases blood flow in femoral vein
Mackay MR, Ellis E, Johnston C (2005) Randomised clinical trial of physiotherapy after open abdominal surgery in high risk patients. Austr J Physiother, 51, 151-9
www.physiotherapy.asn.au/ajp/vol_51/3/AustJPhysiotherv51i3Mackay.pdf
yet more research telling us that we dont need to do breathing exercises routinely after surgery; maybe someone will notice it this time!
Maeda H (2010) Hyperglycemia during hepatic resection. Am J Surg, 199, 1, 8-13
following hepatic resection, blood glucose may be destabilised which may have implications for mobilising patients
Morran CG, Flnlay IG, Mathieson M et al (1983) Randomized controlled trial of physiotherapy for postoperative pulmonary complications. Br J Anaesth, 55: 1113 1117
bja.oxfordjournals.org/cgi/content/abstract/55/11/1113?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=55&firstpage=1113&resourcetype=HWCIT
routine postoperative physiotherapy significantly reduced complications
Mynster T (1996) The effect of posture on late postoperative oxygenation. Anaesthesia, 51, 225-7
onlinelibrary.wiley.com/doi/10.1111/j.1365-2044.1996.tb13637.x/abstract
max decrease in FRC occurs 16 hours post-op
SaO2 significantly higher in sitting and standing compared to supine
hypoxaemia contributes to post-op cerebral, cardiac and wound complications
surgical delirium caused by hypoxaemia can be treated with supplemental oxygen
mobilisation improves SaO2 on day 1-4 post op
Nielsen KG, Holte K, Kehlet H (2003) Effects of posture on postoperative pulmonary function. Acta Anaesth Scand, 47, 1270-7
review of controlled trials showing benefits of standing and sitting
Ntoumenopoulos V (1996) Effects of cardiothoracic physiotherapy on intrapulmonary shunt in abdominal surgical patients. Austr Phys, 42, 297-303
evening physiotherapy leads to improved gas exchange after major surgery.
Ogiwara S, Miyachi T (2002) Effect of posture on ventilatory muscle strength. J Phys Ther Sci, 14, 1-5
www.jstage.jst.go.jp/article/jpts/14/1/1/_pdf
inspiratory and expiratory muscles are most effective in the upright position
Olsιn MF et al (1997) Randomised controlled trial of prophylactic chest physiotherapy in major abdominal surgery. Br J Surg, 84, 1535-8
preoperative physiotherapy reduces postop complications, increases SaO2 and improves mobilisation
Olsιn MF (2000) Chest physiotherapy in open and laparoscopic abdominal surgery. Phys Ther Reviews, 5, 125-30
review, including benefits of breathing exercises
Olsιn MF et al (1997) Randomised controlled trial of prophylactic chest physiotherapy in major abdominal surgery. Br J Surg, 84, 1535-8
preoperative physiotherapy reduces postoperative complications, increases saturation and improves mobilisation
Ong CK, Lirk P (2005) The efficacy of preemptive analgesia for acute postoperative pain management. Anesth Analg, 100, 757-73
pre-emptive analgesia by epidural analgesia, local wound infiltration or systemic nonsteroidal anti-inflammatory drugs before surgery.
Pasquina P, Tramer MR, Walder B (2003) Prophylactic respiratory physiotherapy after cardiac surgery: systematic review. Br Med J, 327,1379-1384
www.bmj.com/cgi/content/abstract/327/7428/1379?ijkey=8b4f0635edbb2660bcc2f0b8c88b6433a3c90184&keytype2=tf_ipsecsha
limited high-quality studies leaves prophylactic post-op physiotherapy unproven
Pasquina P, Merlani P (2004) Continuous Positive Airway Pressure versus noninvasive pressure support ventilation to treat atelectasis after cardiac surgery. Anesth Analg, 99, 10018
www.anesthesia-analgesia.org/cgi/content/abstract/99/4/1001?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Pasquina+&searchid=1135624807190_746&FIRSTINDEX=0&sortspec=relevance&volume=99&firstpage=1001+&journalcode=anesthanalg
neither adjunct very helpful for post-op atelectasis, but NIV is preferable.
Pasquina P, Tramer MR, Granier J-M, Walder B (2006) Respiratory physiotherapy to prevent pulmonary complications after abdominal surgery. Chest, 130, 6, 1887 - 99
www.chestjournal.org/cgi/content/abstract/130/6/1887
systematic review identifying a few trials supporting prophylactic post-op physiotherapy
routine physiotherapy not justified
Pratt-Harrington (1995) The effect of osteopathic manipulative treatment in the post abdominal surgical patient. Am Ass Osteopathy J, Fall, 9-13
outcome - improved spirometry readings compared to controls
Searle C, Ghosh S (2002) Perioperative management of the adult patient with respiratory disease. Surgery, 20, 4, 86-91
Smetana GW (2003) Preoperative pulmonary assessment of the older adult. Clin Geriatr Med, 19, 35-55
Smith A (2001) What are the effects of postoperative chest physiotherapy? Clin Evid, 6, 1078-80
evidence for benefits of deep breathing, incentive spirometry, IPPB
Smith MCL (2000) Is retained mucus a risk factor for the development of postoperative atelectasis and pneumonia? Physiother Theory Pract, 16, 69-80
Varela G, Ballesteros E, Jimenez MF et al (2006). Cost-effectiveness analysis of prophylactic respiratory physiotherapy in pulmonary lobectomy. Eur J Cardiothorac Surg, 29, 216-20
ejcts.ctsnetjournals.org/cgi/content/full/29/2/216#TBL1
physiotherapy involving deep breathing and coughing, treadmill, ergometric cycling, and upper limb exercise (starting pre-operatively and continuing until discharge), showed reduced atelectasis, pneumonia and length of stay, compared to incentive spirometry alone
Westerdahl E, Lindmark B, Eriksson T et al (2003) The immediate effects of deep breathing exercises on atelectasis and oxygenation after cardiac surgery. Scand Cardiovasc J, 37, 363-7
www.informaworld.com/smpp/content~db=all?content=10.1080/14017430310014984
a single session of 30 deep-breaths reduces atelectasis and increases oxygenation on the second postoperative day after CABG
ACPRC = Association of Chartered Physiotherapists in Respiratory Care
CABG = coronary artery bypass graft
FRC = functional residual capacity
JAMA = Journal of American Medical Association