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Physiotherapy in upper abdominal surgery - what is current practice in Australia?
Shane Patman1, Alice Bartley1, Allex Ferraz1
1School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Australia.
Archives of Physiotherapy
|January 18, 2018
Summary
Physiotherapists prefer early patient mobilization after upper abdominal surgery (UAS). Many still use routine respiratory treatments, even though evidence suggests mobilization alone may prevent post-operative pulmonary complications (PPCs).
Area of Science:
- Physiotherapy
- Respiratory Medicine
- Surgical Care
Background:
- Upper abdominal surgery (UAS) can lead to post-operative pulmonary complications (PPCs).
- Current physiotherapy practices for UAS patients lack high-quality research, relying on consensus guidelines.
- Guidelines recommend early mobilization and respiratory interventions, but recent evidence questions the necessity of combined treatments.
Purpose of the Study:
- To document physiotherapy assessment measures and interventions used after UAS.
- To evaluate if current practices align with best practice guidelines and recent evidence.
- To identify barriers to effective post-operative physiotherapy.
Main Methods:
- An online survey was distributed to experienced Australian physiotherapists specializing in UAS.
- The survey achieved a 35% response rate from 57 participants.
- Data collected included assessment tools, interventions, and perceived treatment barriers.
Main Results:
- Most physiotherapists routinely mobilize patients on day one post-UAS, if medically stable.
- Routine chest physiotherapy is common, with only 23% of practitioners using mobilization without respiratory intervention.
- Variability exists in screening tools for PPC risk, and patient factors like fatigue hinder treatment initiation.
Conclusions:
- Early mobilization is the preferred post-operative treatment for UAS patients.
- Many physiotherapists continue respiratory interventions despite evidence suggesting limited added benefit.
- Further research is needed to validate current guidelines, identify barriers, and develop effective screening tools for PPC prevention.
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