Osman YAKŞİ, Mehmet ÜNAL, Ali KILIÇGÜN, Alp ÖZEL

Commonly administered physiotherapy techniques inthoracic surgery clinics in Turkey

Aim: The aim of this study was to investigate the physiotherapy techniques in the thoracic surgery clinic in Turkey.Materials and Methods: The data of this research was obtained through the online questionnaire created by the authors. Thequestions in the questionnaire were created by the researcher in parallel with the literature (14 questions). In the questionnaire,descriptive information was asked using multiple-choice question types about chest surgery clinics and applied physiotherapy. Achest surgeon from each participating clinic was asked to respond to the questionnaire. Results: A total of 62 clinics participated in the study. The mean number of monthly operations of these clinics is 0-20 in 51.6%, 21-40in 19.4%, and 41-60 in 19.4%. 64.5% of the clinics participating in the study perform regular physiotherapy practices to their patients.The clinics that applied pulmonary rehabilitation to their patients, 65% of them additionally performed pulmonary rehabilitation in thepreoperative period. The most common applications were early mobilization, airway cleaning techniques, deep breathing exercises,assisted coughing, humidification of the airway, incentive spirometer exercises, forced expiration, and exercise practices. 53.3% ofthe clinics where routine physiotherapy was administered benefited from assistive devices for pulmonary rehabilitation. Conclusion: Although physiotherapy practices are performed in the thoracic surgery clinic in Turkey, they are not at the desired level.Preoperatively pulmonary rehabilitation practice in thoracic surgery is even rarer. Moreover, the content of pulmonary rehabilitationprograms is not standard. The prevalence of evidence-based physiotherapy applications should be increased in thoracic surgeryclinics.

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1. Yesildag C, Erhan E, Deniz MN, et al. Incidence of postthoracotomy chronic pain and its impact on quality of life. Turk J Med Sci 2013;33:1395-401.
2. Alston RP, Ranucci M, Myles PS editors. Oxford textbook of cardiothoracic anaesthesia: Oxford Textbook in Anaesthesia. NY, USA: Oxford University Press; 2015.
3. Rudra A, Das S. Postoperative pulmonary complications. Indian J Anaesth 2006;50:89-98.
4. Fisher BW, Majumdar SR, McAlister FA. Predicting pulmonary complications after nonthoracic surgery: a systematic review of blinded studies. Am J Med 2002;112:219-25.
5. Sengupta S. Post-operative pulmonary complications after thoracotomy. Indian J Anaesth 2015;59:618-26.
6. Ince DI. Respiratory therapy in the intensive care unit. Intensive Care Med 2006;6:28-42.
7. Kostanoglu A, Tarakci E, Dayioglu E, et al. Comparison of Incentive spirometry and Continuous Positive Airway Pressure (CPAP) on the prevention of postoperative pulmonary complications after thoracic surgery. J Health Sci 2014;1:57-67.
8. Ozalevli S. Toraks cerrahisinde postoperatif pulmoner rehabilitasyon. Bull Thorac Surg 2015;6:16-25.
9. Nagarajan K, Bennett A, Agostini P, et al. Is preoperative physiotherapy/pulmonary rehabilitation beneficial in lung resection patients? Interact Cardiovasc Thorac Surg 2011;13:300-2.
10. Ambrosino N, Gabbrielli L. Physiotherapy in the perioperative period. Best Pract Res Clin Anaesthesiol 2010;24:283-9.
11. Pehlivan E, Turna A, Gurses A, et al. The Effects of Preoperative Short-term Intense Physical Therapy in Lung Cancer Patients: A Randomized Controlled Trial. Ann Thorac Cardiovasc Surg 2011;advpub:1107110039.
12. Benzo R, Wigle D, Novotny P, et al. Preoperative pulmonary rehabilitation before lung cancer resection: Results from two randomized studies. Lung Cancer 2011;74:441-5.
13. Porter S. editor. Tidy's Physiotherapy. Edinburg: Elsevier Health Sciences 2013.
14. Agostini PJ, Naidu B, Rajesh P, et al. Potentially modifiable factors contribute to limitation in physical activity following thoracotomy and lung resection: a prospective observational study. J Cardiothorac Surg 2014;9:128.
15. Schaller SJ, Anstey M, Blobner M, et al. Early, goaldirected mobilisation in the surgical intensive care unit: a randomised controlled trial. The Lancet. 2016;388:1377-88.
16. Cesario A, Ferri L, Galetta D, et al. Post-operative respiratory rehabilitation after lung resection for nonsmall cell lung cancer. Lung Cancer 2007;57:175-80.
17. Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med 2013;188:13-64.
18. Bertani A, Ferrari P, Terzo D, et al. A comprehensive protocol for physiokinesis therapy and enhanced recovery after surgery in patients undergoing videoassisted thoracoscopic surgery lobectomy. J Thorac Dis 2018;10:499-511.
19. Freynet A, Falcoz P-E. Is transcutaneous electrical nerve stimulation effective in relieving postoperative pain after thoracotomy? Interac Cardiovasc Thorac Surg 2010;10:283-8.
20. Mans CM, Reeve JC, Elkins MR. Postoperative outcomes following preoperative inspiratory muscle training in patients undergoing cardiothoracic or upper abdominal surgery: a systematic review and meta analysis. Clin Rehabil 2015;29:426-38.
21. Carvalho CR, Paisani DM, Lunardi AC. Incentive spirometry in major surgeries: a systematic review. Braz J Phys Ther 2011;15:343-50.
22. Agostini P, Naidu B, Cieslik H, et al. Effectiveness of incentive spirometry in patients following thoracotomy and lung resection including those at high risk for developing pulmonary complications. Thorax 2013;68:580-5.