Pre- and postoperative physiotherapyAgostini PJ, Naidu B, Rajesh P et al (2014) Potentially modifiable factors contribute to limitation in physical activity following thoracotomy and lung resection: a prospective observational study. J Cardiothoracic Surgery; 9:128. doi: 10.1186/1749-8090-9-128.
Al Jaaly E, Fiorentino F, Reeves BC et al (2013) Effect of adding postoperative noninvasive ventilation to usual care to prevent pulmonary complications in patients undergoing coronary artery bypass grafting: a randomized controlled trial. J Thorac Cardiovasc Surg; 146(4):912-8. doi: 10.1016/j.jtcvs.2013.03.014
Baddeley RA (2016) Physiotherapy for enhanced recovery in thoracic surgery. J Thoracic Dis; 8(Suppl 1):S107-S110. doi: 10.3978/j.issn.2072-1439.2015.12.02.
Bal-Bocheńska MA (2016) Evaluation of the effects of rehabilitation after surgery using the Ravitch and Nuss methods: a case study. Kardiochirurgia i Torakochirurgia Polska (Polish Journal of Cardio-Thoracic Surgery); 13(1):72-77. doi: 10.5114/kitp.2016.58973.
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
Basse L (2000) A clinical pathway to accelerate recovery after colonic resection. Ann Surg, 232, 51-7
• post-op rehab reduces hospital stay
Boden I, Browning L, Skinner EH et al (2016) The LIPPSMAck POP (Lung Infection Prevention Post Surgery - Major Abdominal - with Pre-Operative Physiotherapy) trial: study protocol for a multi-centre randomised controlled trial. Trials; 16:573. doi: 10.1186/s13063-015-1090-6.
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
• 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
Branson RD (2013) The scientific basis for postoperative respiratory care. Respir Care; 58(11):1974-84
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
Brocki BC, Andreasen JJ, Langer D et al (2016) Postoperative inspiratory muscle training in addition to breathing exercises and early mobilization improves oxygenation in high-risk patients after lung cancer surgery: a randomized controlled trial. Eur J Cardiothorac Surg; 49(5):1483-91. doi: 10.1093/ejcts/ezv359
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
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 Physiotherapy, 53, 1, 47-52
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
• a symptom-limited stair climbing test accurately predicts cardiopulmonary complications
Bruton A, Donovan H, Langridge E (2009) The Southampton physiotherapy post-operative screening tool. ACPRC Journal, 41, 9-15
Cereda M, Neligan PJ, Reed AJ (2013) Noninvasive respiratory support in the perioperative period. Curr Opin Anaesthesiol; 26(2):134-40. doi: 10.1097/ACO.0b013e32835e8002.
Cheifetz O, Lucy D, Overend TJ (2010) The effect of abdominal support on functional outcomes in patients following major abdominal surgery. Physiother Can, 62, 3, 242-53
Choi WW, Au TK, Fung YK et al (2013) Efficacy of a perioperative physiotherapy care programme for patients undergoing abdominal surgery in Tseung Kwan O Hospital. Hong Kong Physiother J, 31(2):102-103
Coen PM, Goodpaster BH (2016) A role for exercise after bariatric surgery? Diabetes Obes Metab; 18(1):16-23. doi: 10.1111/dom.12545
Cordeiro AL, Melo TA, Neves D et al (2016) Inspiratory muscle training and functional capacity in patients undergoing cardiac surgery. Braz J Cardiovasc Surg; 31(2):140-4. doi: 10.5935/1678-9741.20160035
Czyżewski P, Hryciuk D, Dąbek A et al (2016) Assessment of abdominal belts impact on the lungs ventilation and their application in early physiotherapy after major abdominal surgery - prospective trial. Pol Przegl Chir; 88(4):202-8. doi: 10.1515/pjs-2016-0052
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
Dhesi JK, Swart M (2016) Specialist pre-operative assessment clinics. Anaesthesia; 71(S1):3–8. doi: 10.1111/anae.13307
• the pre-assessment clinic should include rehabilitation and discharge planning
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 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
Edvardsen E, Skjønsberg OH, Holme I et al (2015) High-intensity training following lung cancer surgery: a randomised controlled trial. Thorax; 70:244-250. doi:10.1136/thoraxjnl-2014-205944
• high-intensity endurance and strength training after lung cancer surgery is well tolerated and improves fitness and quality of life
Faintuch J (2013) Rehabilitation needs after bariatric surgery. Europ J Phys Rehab Med, 49(3): 431-7
Fernandes SC da S, dos Santos RS, Giovanetti EA et al (2016) Impact of respiratory therapy in vital capacity and functionality of patients undergoing abdominal surgery. Einstein; 14(2):202-207. doi: 10.1590/S1679-45082016AO3398.
Halm MA (2015) East meets West: effects of massage on the experience of cardiac surgery patients. Am J Crit Care; 24:176-180. doi:10.4037/ajcc2015947
Hansen D, Roijakkers R, Jacvkmaert L (2017) Compromised cardiopulmonary exercise capacity in patients early after endoscopic atraumatic coronary artery bypass graft: implications for rehabilitation. Am J Phys Med Rehabil; 96(2):84–92
Hatt K, Kinback NC, Shah A et al (2016) A review of lung transplantation and its implications for the acute rehabilitation team. PM R; S1934-1482(16)30971-6. doi: 10.1016/j.pmrj.2016.09.013
Hoffman AJ, Brintnall RA, Brown JK et al (2014) Too sick not to exercise: using a 6-week, home-based exercise intervention for cancer-related fatigue self-management for postsurgical non-small cell lung cancer patients. Cancer Nurs; 36(3):175-88. doi: 10.1097/NCC.0b013e31826c7763.
• postoperative home-based exercise can reduce fatigue
Hulzebos EH, Smit Y, Helders PP et al (2013) Preoperative physical therapy for elective cardiac surgery patients. Cochrane Database Syst Rev. Nov 14;11:CD010118. doi: 10.1002/14651858.CD010118.pub2.
Imperatori A, Grande A, Castiglioni M et al (2016) Chest pain control with kinesiology taping after lobectomy for lung cancer: initial results of a randomized placebo-controlled study. Interact Cardiovasc Thorac Surg; 23(2):223-30. doi: 10.1093/icvts/ivw110
• postoperative chest pain reduced by kinesiology taping at the chest access site pain trigger point, the ipsilateral deltoid/trapezius and lower anterior chest
Jarski RW (2000) The effectiveness of osteopathic manipulative treatment following surgery. Alt Therapies, 6, 5, 77-81
• outcome: stairs done 20% earlier, walking 43% further, less analgesia, shorter hospital stays than control group
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
Keeratichananont W, Thanadetsuntorn C, Keeratichananont S (2016) Value of preoperative 6-minute walk test for predicting postoperative pulmonary complications. Ther Adv Respir Dis; 10(1):18-25. doi: 10.1177/1753465815615509
Lugg ST, Agostini PJ, Tikka T et al (2016) Long-term impact of developing a postoperative pulmonary complication after lung surgery. Thorax; 71(2):171-6. doi: 10.1136/thoraxjnl-2015-207697
Maeda K, Higashimoto Y, Honda N et al (2016) Effect of a postoperative outpatient pulmonary rehabilitation program on physical activity in patients who underwent pulmonary resection for lung cancer. Geriatr Gerontol Int; 16(5):550-5. doi: 10.1111/ggi.12505
Marseu K, Slinger P (2016) Peri-operative pulmonary dysfunction and protection. Anaesthesia; 71 Suppl 1:46-50. doi: 10.1111/anae.13311
• pre-operative exercise training reduces postoperative pulmonary complications
Martin PS, Braga AC, Meira CA et al (2013) Implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stay. Rev Port Pneumol; 20(2)69–77. doi: 10.1016/j.rppneu.2013.07.005
Martin JB, Garbee D, Bonanno L (2016) Effectiveness of positive end-expiratory pressure, decreased fraction of inspired oxygen and vital capacity recruitment maneuver in the prevention of pulmonary atelectasis in patients undergoing general anesthesia: a systematic review. JBI Database System Rev Implement Rep; 13(8):211-49. doi: 10.11124/jbisrir-2015-1410
Melam GR, Buragadda S, Alhusaini AA et al (2016) Effect of complete decongestive therapy and home program on health- related quality of life in post mastectomy lymphedema patients. BMC Women’s Health; 16:23. doi: 10.1186/s12905-016-0303-9.
Moran J, Wilson F, Guinan E et al (2016) Role of cardiopulmonary exercise testing as a risk-assessment method in patients undergoing intra-abdominal surgery: a systematic review. Br J Anaesth; 116(2):177-91. doi: 10.1093/bja/aev454
• exercise testing is a useful preoperative risk-stratification tool that can predict postoperative outcome
Oikawa M, Hanada M, Hidaka S et al (2016) Current status of perioperative rehabilitation in patients who undergo esophagectomy for cancer. Kyobu Geka; 69(1):59-64
• oesophagectomy brings the highest rate of respiratory complications of any operation, although these are reduced by perioperative rehabilitation
Polastri M, Dell’Amore A, Zagnoni G et al (2016) Preoperative physiotherapy in subjects with idiopathic pulmonary fibrosis qualified for lung transplantation: implications on hospital length of stay and clinical outcomes. J Thoracic Dis; 8(5):E264-E268. doi: 10.21037/jtd.2016.03.52.
Pasqua F (2012) Intensive long-term pulmonary rehabilitation program after oesophagectomy, a reflection. Multidisciplinary Respir Med, 7, 22. doi:10.1186/2049-6958-7-22
Pasquina P, Tramer MR, Granier J-M et al (2006) Respiratory physiotherapy to prevent pulmonary complications after abdominal surgery. Chest, 130, 6, 1887 - 99
• routine physiotherapy is not justified
Peres ACAM (2017) Body posture after mastectomy: comparison between immediate breast reconstruction versus mastectomy alone. Physiother Res Internat; 22(1): e1642. doi: 10.1002/pri.1642
Petree K (2015) Postoperative singultus: an osteopathic approach. J Am Osteopath Assoc; 115(3):166-8. doi: 10.7556/jaoa.2015.030
• manipulation for postop hiccups
Pouwels S et al (2015) Preoperative exercise therapy in lung surgery patients: a systematic review. Respir Med; 109(12):1495-504. doi: 10.1016/j.rmed.2015.08.009
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
Rodriguez-Larrad A, Vellosillo-Ortega JM, Ruiz-Muneta C et al (2016) Postoperative respiratory exercises reduce the risk of developing pulmonary complications in patients undergoing lobectomy. Arch Bronconeumol; 52(7):347-53. doi: 10.1016/j.arbres.2015.11.017
• postoperative complications reduced by early mobilisation, deep breathing with and without incentive spirometry, chest clearance if required and progressive shoulder and thoracic weight-free mobility exercises
Romera-Villegas A, Cairols-Castellote MA, Vila-Coll R et al (2008) Early mobilisation in patients with acute deep vein thrombosis does not increase the risk of a symptomatic pulmonary embolism. International Angiology; 27(6):494-9
• early walking does not influence the incidence of symptomatic pulmonary embolism.
Sala V, Petrucci L, Monteleone S et al (2016) Oxygen saturation and heart rate monitoring during a single session of early rehabilitation after cardiac surgery. Europ J Phys Rehab Med; 52(1):12-9
Santos PMR, Ricci NA, Suster EAB et al (2017) Effects of early mobilisation in patients after cardiac surgery: a systematic review. Physiotherapy; 103(1):1–12. doi: dx.doi.org/10.1016/j.physio.2016.08.003
• early mobility helps to prevent complications, improve functional capacity and reduce length of stay
Schaller SJ, Anstey M, Blobner M et al (2016) Early, goal-directed mobilisation in the surgical intensive care unit: a randomised controlled trial. Lancet; 1;388(10052):1377-1388. doi: 10.1016/S0140-6736(16)31637-3
Shakouri SK, Salekzamani Y, Taghizadieh A et al (2016) Effect of respiratory rehabilitation before open cardiac surgery on respiratory function: a randomized clinical trial. J Cardiovasc Thorac Res; 7(1):13-17. doi:10.15171/jcvtr.2015.03.
Silva YR, Li SK, Rickard MJFX (2013) Does the addition of deep breathing exercises to physiotherapy-directed early mobilisation alter patient outcomes following high-risk open upper abdominal surgery? Cluster randomised controlled trial. Physiother, 99, 3, 187-193
Smith MCL (2000) Is retained mucus a risk factor for the development of postoperative atelectasis and pneumonia? Physiother Theory Pract, 16, 69-80
Singh PM, Borle A, Shah D et al (2016) Optimizing prophylactic CPAP in patients without obstructive sleep apnoea for high-risk abdominal surgeries: a meta-regression analysis. Lung; 194(2): 201-217. doi: 10.1007/s00408-016-9855-6
• prophylactic postoperative CPAP reduces the incidence of postoperative pulmonary complications in patients undergoing high-risk abdominal surgery.
• the protective effect diminishes with increasing level of CPAP
Sterzi S (2013) Post-operative rehabilitation for surgically resected non-small cell lung cancer patients: Serial pulmonary functional analysis. J Rehab Med, 45(9):911-915. doi: 10.2340/16501977-1192
Stokes JW, Wanderer JP, McEvoy MD (2016) Significant discrepancies exist between clinician assessment and patient self-assessment of functional capacity by validated scoring tools during preoperative evaluation. Periop Med; 5(18). doi: 10.1186/s13741-016-0041-4
Takahama M, Mimura Y, Matsuda E (2013) Complications influence ambulation in patients undergoing extrapleural pneumonectomy. Hong Kong Physiother J, 31(1):52-53
Tandon M, Singh A, Saluja V et al (2016) Validation of a new “objective pain score” vs. “numeric rating scale” for the evaluation of acute pain: a comparative study. Anesthesiology Pain Med; 6(1):e32101. doi: 10.5812/aapm.32101.
• acute pain in the post-operative period should be assessed at rest and during movement
Thrush A, Skrzat J (2016) Provision of physical therapy at a long-term acute care hospital for patients awaiting lung transplantation: a case report with 3 participants. Cardiopul Phys Ther J: 27(4):122–130. doi: 10.1097/CPT.0000000000000037
Valkenet K, Trappenburg JC, Schippers CC et al (2016) Feasibility of exercise training in cancer patients scheduled for elective gastrointestinal surgery. Dig Surg; 33(5):439-47. doi: 10.1159/000445958
Van der Leeden M, Huijsmans R, Geleijn E et al (2016) Early enforced mobilisation following surgery for gastrointestinal cancer: feasibility and outcomes. Physiotherapy; 102(1):103–110. doi: dx.doi.org/10.1016/j.physio.2015.03.3722
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
• 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 (2015) Optimal technique for deep breathing exercises after cardiac surgery. Minerva Anestesiol; 81(6):678-83
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
• a single session of 30 deep-breaths reduces atelectasis and increases oxygenation on the second postoperative day after CABG
Westerdahl E (2005) Deep-breathing exercises reduce atelectasis and improve pulmonary function after coronary artery bypass surgery Chest, 128: 3482-8.
• patients who performed 30 slow deep breaths (against a positive expiratory pressure of 10 cm H2O) hourly during daytime for the first 4 postoperative days after CABG had significantly smaller atelectatic areas and better pulmonary function.
Wickerson L, Rozenberg D, Janaudis-Ferreira T et al (2016) Physical rehabilitation for lung transplant candidates and recipients: An evidence-informed clinical approach. World J Transplant; 6(3):517-531. doi: 10.5500/wjt.v6.i3.517.
Wiskemann J, Schommer K, Jaeger D et al (2016) Exercise and cancer: return to work as a firefighter with ostomy after rectal carcinoma - a case report. Medicine (Baltimore); 95(29):e4309. doi: 10.1097/MD.0000000000004309
Yip VS, Dunne DF, Samuels S (2016) Adherence to early mobilisation: key for successful enhanced recovery after liver resection. Eur J Surg Oncol; 42(10):1561-7. doi: 10.1016/j.ejso.2016.07.015.
ACPRC = Association of Chartered Physiotherapists in Respiratory Care
CABG = coronary artery bypass graft
FRC = functional residual capacity
JAMA = Journal of American Medical Association