The physiotherapy management of patients undergoing thoracic surgery: a survey of current practice in Australia and New Zealand

Reeve J.; Denehy L. and Stiller K.

This study looks at the current physiotherapy practices in Australia and New Zealand  in patients undergoing thoracic surgery. A purpose-designed postal questionnaire was distributed to senior physiotherapists in all thoracic surgical units throughout Australia and new Zealand, to establish current physiotherapy management of patients undergoing thoracic surgery and the factors which influence that practice.

The results showed the following (expressed as a percentage of respondents); 35% assessed all patients pre-operatively, 96% saw all patients post-operatively, 63% used prophylactic physiotherapy to prevent post-operative complications, 80% commenced treatment on the first post-operative day with the most common interventions being deep breathing exercises, the active cycle of breathing techniques, cough, forced expiration techniques and sustained maximal inspirations. Of the respondents 89% sat the patients out of bed, 50% started shoulder range of movement exercises and 70% commenced walking on day 1. Few respondents offered post-operative pulmonary rehabilitation, out-patient follow up or post-thoracotomy pain management.

The study highlights the fact that there is little research available for clinicians to base their practice on resulting in no clear guidelines for handling patients with persistent air-leaks, when to start shoulder range of movements, thoracic mobility exercises or stair climbing.

Physiotherapy Research International 2007, 12(2):59-71

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