Chest Physical Therapy for the Postoperative or Traumatic Injury Patient

Abstract

Techniques of chest physical therapy have been used since the early 1900s to decrease postoperative pulmonary complications. Through investigations since the 1950s, documentation as to the efficacy of chest physical therapy in actually reducing postoperative pulmonary complications has been published. However, the careful documentation of techniques employed (such as full Trendelenburg's position versus a modified position and vibration of particular force and frequency) has not been done. Also, because of an inability to specify the risk factors of postoperative pulmonary complications occurring in particular patients or to qualitate the occurrence of these complications, it is difficult to establish what treatment is most efficacious. This article is a critical review of investigations to date with recommendations for further research stemming from this review.

Randomized controlled trial of prophylactic chest physiotherapy in major abdominal surgery

“…Many studies have demonstrated the effectiveness of chest physiotherapy 3,[13][14][15][16][17][18]20,[22][23][24][25][26][27][28][29][30] . However, only a few have had an untreated control group 3,14,[16][17][18] .…”

“…Before operation all patients were classified with an American Society of Anesthesiologists (ASA) score 19 and were also placed in a high-or low-risk group for developing postoperative pulmonary complications 13,20 . Criteria for high risk included age over 50 years and at least one of the following: smoker or exsmoker for less than 12 months, body mass index (BMI) 21 greater than 30 kg/m 2 , pulmonary disease with need for daily medication, and a history of other medical condition causing reduced ventilatory function.…”

Early Respiratory Therapy Reduces Postoperative Atelectasis in Children Undergoing Lung Resection

“…[10][11][12] A variety of respiratory physiotherapeutic techniques have been evaluated for their ability to reduce postoperative pulmonary complications and previous pulmonary disease exacerbations. 2,14,15 However, the details of many of these techniques have not been well described. 14,15 In the literature there are few case reports mentioning the application of postoperative respiratory physiotherapy following lung resection in children.…”

“…2,14,15 However, the details of many of these techniques have not been well described. 14,15 In the literature there are few case reports mentioning the application of postoperative respiratory physiotherapy following lung resection in children. [16][17][18] Additionally, none of these studies described an ideal time for beginning respiratory intervention maneuvers.…”

Chest physical therapy in surgery: a theoretical model about who to treat

“… Since the early 1900s, physiotherapists have treated surgical patients to prevent post-operative pulmonary complications (PPC) [1]. Chest physiotherapy originated in the UK and, in 1915, one of the first articles was published describing breathing exercises to restore respiration following damage to the pleura, lung and diaphragm [2].…”