Preoperative physical therapy for elective cardiac surgery patients

Area of Science:

• Cardiology
• Pulmonology
• Physical Therapy

Background:

• Postoperative pulmonary complications are common after cardiac surgery.
• Physical therapy is a standard intervention to prevent these complications.

Purpose of the Study:

• To assess the effectiveness of preoperative physical therapy in preventing postoperative pulmonary complications in cardiac surgery patients.
• To identify patient subgroups that benefit most and the most effective physical therapy approaches.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs) and quasi-RCTs.
• Searches conducted across multiple databases including CENTRAL, MEDLINE, EMBASE, PEDro, and CINAHL.
• Included studies compared preoperative physical therapy (aerobic, breathing exercises, or inspiratory muscle training) with no therapy or sham therapy in adult cardiac surgery patients.

Main Results:

• Eight RCTs involving 856 patients were analyzed.
• Preoperative physical therapy reduced the risk of postoperative atelectasis (RR 0.52) and pneumonia (RR 0.45).
• A significant reduction in postoperative hospital stay (mean difference -3.21 days) was observed; no significant effects on pneumothorax, prolonged ventilation, or all-cause mortality were found.

Conclusions:

• Preoperative physical therapy appears effective in reducing atelectasis and pneumonia following elective cardiac surgery.
• The intervention also leads to a shorter hospital stay.
• Evidence is insufficient to support its use for preventing pneumothorax, prolonged mechanical ventilation, or reducing all-cause mortality.