A postoperative shoulder exercise program improves function and decreases pain following open thoracotomy: a randomised trial
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Reeve, J
Stiller, K
Nicol, K
McPherson, KM
Birch, P
Gordon, IR
Denehy, L
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Journal Article
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Australian Physiotherapy Association
Abstract
QUESTION: Does a postoperative physiotherapy exercise program incorporating shoulder exercises improve shoulder function, pain, range of motion, muscle strength, and health-related quality of life in patients undergoing elective pulmonary resection via open thoracotomy? DESIGN: Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis. PARTICIPANTS: 76 patients who underwent pulmonary resection via open thoracotomy. INTERVENTION: All participants received standard medical and nursing care involving a clinical pathway. The experimental group also received physiotherapy interventions that included daily supervised, progressive exercises until discharge and a postoperative exercise booklet on discharge. OUTCOME MEASURES: Preoperatively and up to 3 months postoperatively pain was measured with a numerical rating scale, shoulder function with the Shoulder Pain and Disability Index, and quality of life with the Short Form-36. Shoulder range of motion and muscle strength were measured in a subgroup. RESULTS: The experimental group had 1.3 units (95% CI 0.3 to 2.2) less shoulder pain (scored /10) and 2.2 units (95% CI 0.2 to 4.3) less total pain (scored /30) at discharge, and 7.6% (95% CI 1.7 to 13.6) better function at 3 months. The Short Form-36 physical component score was 4.8 points (95% CI -0.3 to 10.0) better for the experimental group than the control group at 3 months. Differences between groups in all range of motion and strength measures were small and statistically non-significant. CONCLUSION: A physiotherapist-directed postoperative exercise program resulted in significant benefits in pain and shoulder function over usual care for patients following open thoracotomy.Description
Keywords
Randomised controlled trial, Physical therapy (specialty), Thoracotomy, Postoperative complications, Pain, Postoperative pain, Shoulder, Exercise, Muscle sparing thoracotomy, Assisted thorasic surgery, Posterolateral thoracotomy, Standard, Questionnaires, Resection, Strength, Care
Source
Journal of Physiotherapy, vol.56(4), pp.245-252
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© Australian Physiotherapy Association 2010. The definitive version was published in (see Citation). The original publication is available at (see Publisher's Version).