Pre- and postoperative physiotherapy
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

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

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

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 Physiotherapy, 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

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

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

Chiumello D et al (2011) Non-invasive ventilation in postoperative patients: a systematic review Intensive Care Med, 37:918–929

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

Cook DJ (2013) Functional recovery in the elderly after major surgery: assessment of mobility recovery using wireless technology. Ann Thorac Surg; 96(3):1057-61

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

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 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

Faintuch J (2013) Rehabilitation needs after bariatric surgery. Europ J Phys Rehab Med, 49(3): 431-7

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

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 EHJ, Helders PJM, Favie NJ (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
• high-risk patients may benefit from preoperative inspiratory muscle training

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.
• postoperative atelectasis and pneumonia may be reduced by preoperative exercise and breathing exercises

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

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

Kulkarni SR et al (2010) Pre-operative inspiratory muscle training preserves postoperative inspiratory muscle strength following major abdominal surgery – a randomised pilot study
Ann R Coll Surg Engl; 92(8): 700–705. doi: 10.1308/003588410X12771863936648

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

McConnelee LE (2009) Pre- and postcardiopulmonary rehabilitation in hospitalized patients undergoing coronary artery bypass surgery: a randomized control trial. Am J Phys Med Rehab, 88, 7, 591-592

Nerbass FB, Feltrim MIZ, de Souza SA et al (2010) Effects of massage therapy on sleep quality after coronary artery bypass graft surgery. Clinics (Sao Paulo), 65, 11, 1105–1110. doi: 10.1590/S1807-59322010001100008
www.ncbi.nlm.nih.gov/pmc/articles/PMC2999703/?tool=pmcentrez
• massage therapy is an effective technique for improving patient recovery from cardiopulmonary artery bypass graft surgery because it reduces fatigue and improves sleep

Nikolić I, Majerić-Kogler V, Plavec D (2008) Stairs climbing test with pulse oximetry as predictor of early postoperative complications in functionally impaired patients with lung cancer and elective lung surgery: prospective trial of consecutive series of patients. Croat Med J, 49, 1, 50–57. doi: 10.3325/cmj.2008.1.50
www.ncbi.nlm.nih.gov/pmc/articles/PMC2269232/?tool=pmcentrez

Olsén 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

Olsén 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

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
www.mrmjournal.com/content/7/1/22

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, 1001–8
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

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 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

Souza 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

Squadrone V, Coha M, Cerutti E et al (2005) Continuous positive airway pressure for treatment of postoperative hypoxemia: A randomized controlled trial. JAMA, 293, 589–95
www.ncbi.nlm.nih.gov/pubmed/15687314

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

Takahama M, Mimura Y, Matsuda E (2013) Complications influence ambulation in patients undergoing extrapleural pneumonectomy. Hong Kong Physiother J, 31(1):52-53

Tomczak CR et al (2013) Effect of exercise training on pulmonary oxygen uptake kinetics in heart transplant recipients. Am J Cardiol; 112(9):1489-1492

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

Westerdahl E (2005) Deep-breathing exercises reduce atelectasis and improve pulmonary function after coronary artery bypass surgery Chest, 128: 3482-8.
www.chestjournal.org
• 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.


ACPRC = Association of Chartered Physiotherapists in Respiratory Care
CABG = coronary artery bypass graft
FRC = functional residual capacity
JAMA = Journal of American Medical Association