Postoperative exercise training is associated with reduced respiratory infection rates and early discharge: A case-control study

Abstract

Available online xxxResults: The rate of RTI was only 16.6% in the exercise group and 43.3% in the control group (P ¼ 0.024). None of the cases or controls suffered from a DVT or PE. Median postoperative length of stay in the control group was 11 ± 7.5 days whereas in the cases it was 8.5 ± 5.00 days (P ¼ 0.049). The Borg subjective breathlessness score in the cases group showed a decline in the subjective breathlessness on postoperative day 4 (P ¼ 0.002).Conclusions: Early aerobic activity with a pedal exerciser halves the rate of postoperative RTI and postoperative hospital stay after complex abdominal surgery. Subjective breathlessness was also reduced with the use of pedal exerciser, signifying potential to improve exercise endurance in the postoperative patient.

Physiotherapy in upper abdominal surgery – what is current practice in Australia?

“…Stair climbing was not necessarily being prescribed as an intervention despite physiotherapists expecting patients to achieve it as a milestone. Respondents also indicated that cycle pedals are an uncommon intervention post-operatively despite Bhatt and colleagues [ 6 ] determining that early aerobic exercise through the use of cycle pedals halved the rate of respiratory infection and length of stay. This was, however, a small single-centre study that needs to be validated prior to translation into standard physiotherapy practice in upper abdominal surgery patients.…”

“…There is no published consensus around the optimal assessment tool(s) to screen patients for risk of PPC development and/or to evaluate the effectiveness of physiotherapeutic treatment post-UAS. Similarly, consensus on intervention effectiveness is currently absent, with recent research unable to demonstrate any physiotherapy technique to be superior than another at preventing PPCs [ 6 ]. Physiological outcomes of deep breathing exercises (DBEx) are variable, with many concluding that a reduction in respiratory capacity occurs regardless of prophylactic DBEx treatment [ 2 ].…”

Effectiveness of ambulation to prevent venous thromboembolism in patients admitted to hospital: a systematic review

“…After title, abstract and fulltext reviews using inclusion criteria, 14 354 articles were excluded, leaving 18 articles for analysis ( Figure 1). Of the included articles, 2 studies were prospective cohort studies; 30,31 1 was described as a case-control study, although it was a matched retrospective cohort study; 32 7 were retro spective cohort studies involving surgical patients; [33][34][35][36][37][38][39] and 7 were RCTs [40][41][42][43][44][45][46] with an additional study of a secondary analy sis of the randomized Medical Patients with Enoxaparin (MEDENOX) trial (Table 1). 47…”

“…46 A venous thromboembolism event was a secondary outcome in 7 studies. 31,32,37,39,42,43,45 The use of pharmacologic prophylaxis for venous thromboembol ism varied: 6 studies prescribed prophylaxis for all patients, 8 did not report prophylaxis use, 2 did not use prophylaxis and 2 had different regimens by group. The heterogeneity of studies regarding patient populations, pharmacologic prophy laxis and ambulatory interventions precluded the aggregation of data for metaanalysis.…”

Prophylactic penehyclidine inhalation for prevention of postoperative pulmonary complications in high-risk patients: study protocol of a randomized controlled trial

“…Using effective strategies to prevent PPCs is essential in high-risk patients. Some strategies have been proved beneficial in previous studies, such as smoking cessation [ 14 ] and inspiratory muscle training [ 15 , 16 ] before surgery; use of regional anesthesia [ 17 , 18 ], lung-protective ventilation (for patients who received general anesthesia) [ 19 , 20 ] and goal-directed fluid therapy [ 21 ] during surgery; as well as use of continuous positive airway pressure or noninvasive ventilation [ 22 , 23 ] and early exercise [ 24 , 25 ] after surgery. High-risk patients, such as those complicated with bronchial asthma, chronic obstructive pulmonary disease (COPD), pneumonia, left ventricular dysfunction and morbid obesity, tend to develop AHR during the perioperative period [ 26 – 28 ], which increase the risk of PPCs.…”