What is the role of post-operative physiotherapy in general surgical Enhanced Recovery after Surgery pathways?

Burgess, Louise; Immins, Tikki; Wainwright, Tom

doi:10.1080/21679169.2018.1468813

Cited by 3 publications

(4 citation statements)

References 48 publications

(49 reference statements)

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“…Some evidence suggests that ERAS reduces overall nursing workload . The optimal mobilization and rehabilitation strategies in ERAS still need to be assessed both in general surgery and in orthopedics for postdischarge rehabilitation …”

Section: Eras Todaymentioning

confidence: 99%

Opportunities and Challenges for the Next Phase of Enhanced Recovery After Surgery

et al. 2021

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ERAS) is a global surgical quality improvement initiative now firmly entrenched within the field of perioperative care. Although ERAS is associated with significant clinical outcome improvements and cost savings in numerous surgical specialties, several opportunities and challenges deserve further discussion.OBSERVATIONS Uptake and implementation of ERAS Society guidelines, together with ERAS-related research, have increased exponentially since the inception of the ERAS movement. Opportunities to further improve patient outcomes include addressing frailty, optimizing nutrition, prehabilitation, correcting preoperative anemia, and improving uptake of ERAS worldwide, including in low-and middle-income countries. Challenges facing enhanced recovery today include implementation, carbohydrate loading, reversal of neuromuscular blockade, and bowel preparation. The COVID-19 pandemic poses both a challenge and an opportunity for ERAS. CONCLUSIONS AND RELEVANCETo date, ERAS has achieved significant benefit for patients and health systems; however, improvements are still needed, particularly in the areas of patient optimization and systematic implementation. During this time of global crisis, the ERAS method of delivering care is required to take surgery and anesthesia to the next level and bring improvements in outcomes to both patients and health systems.

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Section: Eras Todaymentioning

confidence: 99%

Opportunities and Challenges for the Next Phase of Enhanced Recovery After Surgery

et al. 2021

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“…So far, however, no consensus has been defined regarding the type, frequency, and intensity of physical therapy in liver surgery [ 218 ].…”

Section: Resultsmentioning

confidence: 99%

“…An early postoperative mobilization program based on supervised exercises improved functional capacity in patients undergoing major elective abdominal oncologic surgery [217]. So far, however, no consensus has been defined regarding the type, frequency, and intensity of physical therapy in liver surgery [218].…”

Section: Early and Scheduled Mobilizationmentioning

confidence: 99%

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations 2022

et al. 2022

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Background Enhanced Recovery After Surgery (ERAS) has been widely applied in liver surgery since the publication of the first ERAS guidelines in 2016. The aim of the present article was to update the ERAS guidelines in liver surgery using a modified Delphi method based on a systematic review of the literature. Methods A systematic literature review was performed using MEDLINE/PubMed, Embase, and the Cochrane Library. A modified Delphi method including 15 international experts was used. Consensus was judged to be reached when >80% of the experts agreed on the recommended items. Recommendations were based on the Grading of Recommendations, Assessment, Development and Evaluations system. Results A total of 7541 manuscripts were screened, and 240 articles were finally included. Twenty-five recommendation items were elaborated. All of them obtained consensus (>80% agreement) after 3 Delphi rounds. Nine items (36%) had a high level of evidence and 16 (64%) a strong recommendation grade. Compared to the first ERAS guidelines published, 3 novel items were introduced: prehabilitation in high-risk patients, preoperative biliary drainage in cholestatic liver, and preoperative smoking and alcohol cessation at least 4 weeks before hepatectomy. Conclusions These guidelines based on the best available evidence allow standardization of the perioperative management of patients undergoing liver surgery. Specific studies on hepatectomy in cirrhotic patients following an ERAS program are still needed.

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“…Physiotherapy (PT) is an effective and vital component of rehabilitation for people in many different circumstances, such as but not limited to those with poststroke complications [1,2], chronic diseases [3,4], and those recovering from surgery [5]. Wait times for public physiotherapy are lengthy in multiple Canadian jurisdictions [6][7][8] though they vary between people seeking care for acute compared to chronic conditions [9,10].…”

Section: Introductionmentioning

confidence: 99%

Evaluating Wait Time Management Strategies for Canadian Physiotherapy Services: A Scoping Review

Wenzel,

Duggleby Wenzel

2024

URNCST Journal

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Background: Wait times for publicly-funded physiotherapy (PT) services in Canadasuch as those for outpatients recovering from surgery or children with disabilitiesare high, which may force people to pay for care or face deteriorating quality of life. Specific waitlist management strategies are needed to address this problem, but there is no review on the subject in Cochrane and much of the current research focuses on reducing wait times in emergency rooms or surgery departments. PT is a different context with more flexibility in appointment structure (i.e. length of time or number of patients) and thus more possible strategies to reduce wait times. This scoping review aims to identify which of those have already been studied in the Canadian context. Methods: This review was conducted using Arksey and O'Malley's 2005 framework. EMBASE, Medline, CINAHL, SportDiscus, Canada Commons and Canada Research Index were searched for articles which evaluated wait time management strategies (WTMS) specific for PT services in Canada. A gray literature search of all the PT association and college websites across Canada was also conducted. Results:The eleven studies meeting inclusion criteria were conducted across Canada and evaluated diverse strategies through a range of outcomes. The most frequent were structural/organizational outcomes, but wait times and feedback from professionals were also common. Most often, strategies involved changing how PT services were delivered. Discussion: Further research needs to be done as very few studies were found meeting inclusion criteria. Included studies did not consistently report the context, population, or outcome measurement in enough detail for stakeholders in healthcare to examine the clinical applicability or for future researchers to compare the effectiveness of interventions. No results from the gray literature search were included, suggesting that WTMS for PT are not an area of focus for PT associations and colleges in Canada. Conclusions: There is a need for further evaluation of wait time management strategies in the unique context of PT, with improved reporting in order to make evidence based practice feasible. We suggest that stakeholder groups in healthcare should consider wait time management for PT a higher priority and encourage further research.

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What is the role of post-operative physiotherapy in general surgical Enhanced Recovery after Surgery pathways?

Cited by 3 publications

References 48 publications

Opportunities and Challenges for the Next Phase of Enhanced Recovery After Surgery

Opportunities and Challenges for the Next Phase of Enhanced Recovery After Surgery

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations 2022

Evaluating Wait Time Management Strategies for Canadian Physiotherapy Services: A Scoping Review

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