Preoperative physical therapy in patients undergoing elective cardiac surgery reduced postoperative pulmonary complications and the length of hospital stay by an average of 3 days, according to research from the Netherlands.
Researchers analyzed 856 participants in eight randomized trials; three used a mixed intervention (including either aerobic exercises or breathing exercises) and five studies used inspiratory muscle training.
Those who participated in respiratory physical therapy had few instances of atelectasis and pneumonia, although there was a lack of evidence that preoperative therapy reduced postoperative pneumothorax, prolonged mechanical ventilation, or all-cause deaths, according to researchers. Postoperative death from all causes did not differ between groups.
One study reported a reduced physical function measure on the six-minute walking test in experimental patients compared to controls. One other study reported a better health-related quality of life in experimental patients compared to controls.
Patients who received physical therapy before their operation were part of what lead study author, Erik Hulzebos, PhD, called the “better in, better out strategy.” Hulzebos, a clinical exercise physiologist and physical therapist at the University Medical Center, Utrecht in the Netherlands, noted that “It is important to stratify high and low risk pulmonary risk patients before surgery so the high risk patients can be given tailored care to prevent pulmonary complications post surgery.”