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document
Randomised clinical trial of physiotherapy after open abdominal surgery in high risk patients . Postoperative physiotherapy has been shown to reduce the incidence of postoperative pulmonary complications after open abdominal surgery . This study aimed to determine if the addition of deep breathing exercises and secretion clearing techniques to a standardised physiotherapist-directed program of early mobilisation improved clinical outcomes in patients undergoing open abdominal surgery . Fifty-six patients undergoing open abdominal surgery , at high risk of developing postoperative pulmonary complications , were randomised before operation to an early mobilisation-only group or an early mobilisation-plus-deep breathing and coughing group . Mobility duration , frequency and intensity of breathing interventions were quantified for both groups . All outcomes were assessed by a blinded outcomes researcher using a standardised outcomes measurement tool developed specifically for this population . Outcomes included incidence of clinically significant postoperative pulmonary complications , fever , length of stay , and restoration of mobility . There were no significant differences between groups in mean age , anaesthetic time , perioperative morbidity , or postoperative mobility . Outcome data were available for 89 % of enrolled subjects . Overall incidence of postoperative pulmonary complications was 16 % . The incidence of postoperative pulmonary complications in the non-deep breathing and coughing group was 14 % , and the incidence of postoperative pulmonary complications in the deep breathing and coughing group was 17 % , ( absolute risk reduction -3 % , 95 % C1 -22 to 19 % ) . There was no significant difference between groups in the incidence of fever , physiotherapist time , or the number of treatments . This study suggests that , in this clinical setting , the addition of deep breathing and coughing exercises to a physiotherapist-directed program of early mobilisation does not significantly reduce the incidence of clinically significant postoperative pulmonary complications in high risk open abdominal surgery subjects .
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Intervention_Physical
physiotherapy
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Intervention_Physical
Postoperative physiotherapy
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Intervention_Physical
deep breathing exercises
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Intervention_Physical
secretion clearing techniques
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Intervention_Control
standardised physiotherapist-directed program
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Intervention_Surgical
open abdominal surgery
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Intervention_Educational
randomised before operation to an early
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Intervention_Control
mobilisation-only group
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Intervention_Educational
or an early
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Intervention_Physical
mobilisation-plus-deep breathing
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Intervention_Educational
and
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Intervention_Physical
coughing group
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Intervention_Educational
. Mobility duration , frequency and intensity of breathing interventions were quantified for both groups . All outcomes were assessed by a blinded outcomes researcher using a standardised outcomes measurement tool developed specifically for this population .
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Intervention_Physical
deep breathing
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Intervention_Physical
coughing exercises
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Outcome_Other
reduce the incidence
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Outcome_Physical
Mobility duration
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Outcome_Physical
frequency and intensity of breathing interventions
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Outcome_Physical
clinically significant postoperative pulmonary complications
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Outcome_Physical
fever
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Outcome_Other
length of stay
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Outcome_Physical
restoration of mobility
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Outcome_Other
mean age
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Outcome_Mental
,
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Outcome_Other
anaesthetic time
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Outcome_Physical
perioperative morbidity , or postoperative mobility
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Outcome_Physical
postoperative pulmonary complications
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Outcome_Physical
postoperative pulmonary complications
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Outcome_Physical
postoperative pulmonary complications
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Outcome_Physical
fever
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Outcome_Other
physiotherapist time
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Outcome_Physical
number of treatments
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Participant_Condition
high risk patients
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Participant_Condition
patients undergoing open abdominal surgery
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Participant_Condition
high risk open abdominal surgery subjects