The effects of various respiratory physiotherapies after lung resection: a systematic review

Larsen, Kasper Bro; Skoffer, Birgit; Oestergaard, Lisa Gregersen; Tulder, Maurits W. van; Petersen, Annemette Krintel

doi:10.1080/09593985.2018.1564095

Cited by 8 publications

(11 citation statements)

References 42 publications

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“…In contrast to Gu et al 23 , no systematic increment of θ R and decrement of θ L was observed in the LUL post-operative cases, possibly because of the limited size of our population. Although the characterization and the role of structural modifications on post-operative pulmonary function is still an open field of research 36 , the pre and post-operative values measured angles in our study are in line with the expected intersubject variability, also accounting for the sex-related differences between women and men 37 .…”

Section: Discussionsupporting

confidence: 86%

Functional analysis of the airways after pulmonary lobectomy through computational fluid dynamics

Aliboni

Tullio

Pennati

et al. 2022

Sci Rep

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Pulmonary lobectomy, which consists of the partial or complete resection of a lung lobe, is the gold standard intervention for lung cancer removal. The removal of functional tissue during the surgery and the re-adaptation of the remaining thoracic structures decrease the patient's post-operative pulmonary function. Residual functionality is evaluated through pulmonary function tests, which account for the number of resected segments without considering local structural alterations and provide an average at-the-mouth estimation. Computational Fluid Dynamics (CFD) has been demonstrated to provide patient-specific, quantitative, and local information about airways airflow dynamics. A CFD investigation was performed on image-based airway trees reconstructed before and after the surgery for twelve patients who underwent lobectomy at different lobes. The geometrical alterations and the variations in fluid dynamics parameters and in lobar ventilation between the pre and post-operative conditions were evaluated. The post-operative function was estimated and compared with current clinical algorithms and with actual clinical data. The post-operative configuration revealed a high intersubject variability: regardless of the lobectomy site, an increment of global velocity, wall pressure, and wall shear stress was observed. Local flow disturbances also emerged at, and downstream of, the resection site. The analysis of lobar ventilation showed severe variations in the volume flow rate distribution, highlighting the compensatory effects in the contralateral lung with an increment of inflow. The estimation of post-operative function through CFD was comparable with the current clinical algorithm and the actual spirometric measurements. The results confirmed that CFD could provide additional information to support the current clinical approaches both in the operability assessment and in the prescription of personalized respiratory rehabilitation.

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Section: Discussionsupporting

confidence: 86%

Functional analysis of the airways after pulmonary lobectomy through computational fluid dynamics

Aliboni

Tullio

Pennati

et al. 2022

Sci Rep

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“…The effect of standard respiratory physiotherapy on long-term postoperative complications after lung resection is still an investigation subject, and the role of each structural modification on postoperative pulmonary function is not entirely clear. 51 As already mentioned, regional ventilation globally redistributes to the contralateral side after lobectomy, and the remaining lobes receive a greater flow rate as a compensatory response. Clinical studies reported a decrease in spirometry parameters (FVC and FEV1) after lobectomy, indicating an overall reduction of pulmonary function.…”

Section: Lobementioning

confidence: 89%

“…The effect of standard respiratory physiotherapy on long‐term postoperative complications after lung resection is still an investigation subject, and the role of each structural modification on postoperative pulmonary function is not entirely clear. 51 …”

Section: Discussionmentioning

confidence: 99%

“…However, very little literature exists on quantitative morphological characterization, a field of research in which further studies are required. The effect of standard respiratory physiotherapy on long‐term postoperative complications after lung resection is still an investigation subject, and the role of each structural modification on postoperative pulmonary function is not entirely clear 51 …”

Section: Discussionmentioning

confidence: 99%

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Computational fluid dynamics of the airways after left‐upper pulmonary lobectomy: A case study

Tullio

Aliboni

Pennati

et al. 2021

Numer Methods Biomed Eng

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Pulmonary lobectomy is the gold standard intervention for lung cancer removal and consists of the complete resection of the affected lung lobe, which, coupled with the re-adaptation of the remaining thoracic structures, decreases the postoperative pulmonary function of the patient. Current clinical practice, based on spirometry and cardiopulmonary exercise tests, does not consider local changes, providing an average at-the-mouth estimation of residual functionality. Computational Fluid Dynamics (CFD) has proved a valuable solution to obtain quantitative and local information about airways airflow dynamics. A CFD investigation was performed on the airway tree of a leftupper pulmonary lobectomy patient, to quantify the effects of the postoperative alterations. The patient-specific bronchial models were reconstructed from pre-and postoperative CT scans. A parametric laryngeal model was merged to the geometries to account for physiological-like inlet conditions. Numerical simulations were performed in Fluent. The postoperative configuration revealed fluid dynamic variations in terms of global velocity (+23%), wall pressure (+48%), and wall shear stress (+39%). Local flow disturbances emerged at the resection site: a high-velocity peak of 4.92 m/s was found at the left-lower lobe entrance, with a local increase of pressure at the suture zone (18 Pa). The magnitude of pressure and secondary flows increased in the trachea and flow dynamics variations were observed also in the contralateral lung, causing altered lobar ventilation. The results confirmed that CFD is a patient-specific approach for a quantitative evaluation of fluid dynamics parameters and local ventilation providing additional information with respect to current clinical approaches. K E Y W O R D Scomputational fluid dynamics, imaged-based, pulmonary lobectomy, tracheobronchial tree modeling Marta Tullio and Lorenzo Aliboni equally contributed to this study.

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“…Boutron and Ravaud 2018). Quantitative interrogation is limited to isolated questions such as whether in a particular case it is better to opt for one exercise or another (eg, flexion vs extension) or how many therapeutic interventions should be recommended (cf., eg, Larsen et al . 2020; Ojha et al .…”

Section: Background: Overview Of Contemporary Theorisations Of Physio...mentioning

confidence: 99%

Phenomenological physiotherapy: extending the concept of bodily intentionality

Halák

Kříž

2022

Med Humanities

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This study clarifies the need for a renewed account of the body in physiotherapy to fill sizable gaps between physiotherapeutical theory and practice. Physiotherapists are trained to approach bodily functioning from an objectivist perspective; however, their therapeutic interactions with patients are not limited to the provision of natural-scientific explanations. Physiotherapists’ practice corresponds well to theorisation of the body as the bearer of original bodily intentionality, as outlined by Merleau-Ponty and elaborated upon by enactivists. We clarify how physiotherapeutical practice corroborates Merleau-Ponty’s critical arguments against objectivist interpretations of the body; particularly, his analyses demonstrate that norms of optimal corporeal functioning are highly individual and variable in time and thus do not directly depend on generic physiological structures. In practice, objectively measurable physical deviations rarely correspond to specific subjective difficulties and, similarly, patients’ reflective insights into their own motor deficiencies do not necessarily produce meaningful motor improvements. Physiotherapeutical procedures can be understood neither as mechanical manipulations of patients’ machine-like bodies by experts nor as a process of such manipulation by way of instructing patients’ explicit conscious awareness. Rather, physiotherapeutical practice and theory can benefit from the philosophical interpretation of motor disorders as modifications of bodily intentionality. Consequently, motor performances addressed in physiotherapy are interpreted as relational features of a living organism coupled with its environment, and motor disorders are approached as failures to optimally manage the motor requirements of a given situation owing to a relative loss of the capacity to structure one’s relation with their environment through motor action. Building on this, we argue that the process of physiotherapy is most effective when understood as a bodily interaction to guide patients towards discovering better ways of grasping a situation as meaningful through bodily postures and movements.

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The effects of various respiratory physiotherapies after lung resection: a systematic review

Cited by 8 publications

References 42 publications

Functional analysis of the airways after pulmonary lobectomy through computational fluid dynamics

Functional analysis of the airways after pulmonary lobectomy through computational fluid dynamics

Computational fluid dynamics of the airways after left‐upper pulmonary lobectomy: A case study

Phenomenological physiotherapy: extending the concept of bodily intentionality

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