Article

Investigation of the effects of preoperative physical therapy on
pulmonary function and physical performance before and after upper abdominal
surgery. Design: Non-blind randomized controlled trial. Setting: Tertiary public
hospital and private university, Sao Paulo state, Brazil.
Subjects: Thirty-two
patients undergoing abdominal surgery. Interventions: Patients were randomly
assigned to receive physical therapy, with respiratory and global exercises, 2-3
weeks before surgery (treatment group; n = 16) or await operation without
engaging in practicing (control group; n = 16). After surgery, a physical therapy
protocol was administered to all subjects until the seventh postoperative day.
Main measures: Pulmonary function outcome variables were inspiratory and
expiratory strength, respiratory muscle endurance and spirometry, and physical
performance outcome variables were the functional independence measure and
6-minute walk test distance. Any postoperative pulmonary complications were
recorded. Results: There were no between-group differences at randomization. In
the preoperative period, patients in the intervention group had higher
inspiratory strength and respiratory muscle endurance than controls (88 cmH2O
versus 64 cmH2O and 28 cmH2O versus 23 cmH2O, respectively; P <0 0.05). On the
seventh postoperative day, in addition to inspiratory force and respiratory
muscle endurance, the intervention group showed better results than controls in
the functional independence measure score (118 versus 95) and 6-minute walk test
distance (368.5 m versus 223 m), all P <0 0.05. Postoperative pulmonary
complications occurred in 11 patients in the control group and five in the
intervention group (P = 0.03). Conclusion: Preoperative physical therapy improved
pulmonary function and physical performance in the pre- and postoperative periods
among patients undergoing upper abdominal surgery.

Langue : ANGLAIS