CHEST PHYSICAL THERAPY - COMPARATIVE EFFICACY OF PREOPERATIVE AND POSTOPERATIVE IN THE ELDERLY

  • 1 January 1985
    • journal article
    • research article
    • Vol. 66  (6) , 376-379
Abstract
Although chest physical therapy (PT) immediately after surgery lowers the risk of postoperative pulmonary complications, several reports indicate preoperative chest PT results in further improvement. Chest PT either before and/or after chest surgery in patients over 65 was studied. Two groups were studied, 130 patients (the PRE group) undergoing both pre- and postoperative therapy and 150 patients (the POST group) undergoing only postoperative therapy, dividing them into 4 surgical subgroups: lung, cardiac and other thoracic surgery, upper abdominal and lower abdominal (considered low risk compared with the other 3). Overall complication rates and atelectasis rates were significantly lower in the PRE high-risk subgroups. PRE and POST pneumonia rates, however, were statistically equivalent in all surgical subgroups. Since the low rate of pulmonary complications for PRE-group patients undergoing thoracic or upper abdominal procedures is comparable to that for PRE-group therapy in much younger populations, advanced age alone does not appear to be a significant risk factor. The lack of effect on incidence of pneumonia indicates that preoperative chest PT only counters the altered pulmonary mechanics responsible for atelectasis, but has no effect on pulmonary complications due to infection.

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