What is the role of post-operative physiotherapy in general surgical Enhanced Recovery after Surgery pathways?

Authors: Burgess, L., Immins, T. and Wainwright, T.

http://eprints.bournemouth.ac.uk/30679/

Journal: The European Journal of Physiotherapy

DOI: 10.1080/21679169.2018.1468813

Purpose: Enhanced Recovery after Surgery (ERAS®) has improved outcomes following elective surgery. This narrative review aimed to assess current evidence for post-operative physiotherapy interventions in general surgical procedures which adopt ERAS® principles.

Materials and methods: A systematic review of the literature between 2000 and 2017 was conducted. Randomised controlled trials (RCTs) that compared physiotherapy interventions for patients after the following elective ERAS® procedures were included: gynaecologic, gastrectomy, gastrointestinal, pancreatic, bariatric, head and neck, breast, cystectomy, colorectal, colonic and liver.

Results: One study (two publications) was found to compare post-operative physiotherapy interventions in radical cystectomy patients on an ERAS® pathway. The addition of a progressive exercise-based intervention improved aspects of health-related quality of life (dyspnoea (p <.05), constipation (p <.02) and abdominal flatulence (p ≤ .05)). Enhanced mobilisation was achieved, but no differences were observed in length of stay or severity of complications.

Conclusions: It is essential that the paucity of research to assess post-operative physiotherapy interventions within ERAS® cohorts is highlighted. The results of our literature search highlight that there is a role for post-operative physiotherapy in ERAS® pathways. However, without well-conducted RCTs to evaluate procedure-specific interventions, the optimal type, timing, and dose will not be found and the potential for improving patient functional recovery will be limited.

This data was imported from Scopus:

Authors: Burgess, L.C., Immins, T. and Wainwright, T.W.

http://eprints.bournemouth.ac.uk/30679/

Journal: European Journal of Physiotherapy

Pages: 1-6

eISSN: 2167-9177

ISSN: 2167-9169

DOI: 10.1080/21679169.2018.1468813

© 2018 Informa UK Limited, trading as Taylor & Francis Group Purpose: Enhanced Recovery after Surgery (ERAS®) has improved outcomes following elective surgery. This narrative review aimed to assess current evidence for post-operative physiotherapy interventions in general surgical procedures which adopt ERAS® principles. Materials and methods: A systematic review of the literature between 2000 and 2017 was conducted. Randomised controlled trials (RCTs) that compared physiotherapy interventions for patients after the following elective ERAS® procedures were included: gynaecologic, gastrectomy, gastrointestinal, pancreatic, bariatric, head and neck, breast, cystectomy, colorectal, colonic and liver. Results: One study (two publications) was found to compare post-operative physiotherapy interventions in radical cystectomy patients on an ERAS® pathway. The addition of a progressive exercise-based intervention improved aspects of health-related quality of life (dyspnoea (p <.05), constipation (p <.02) and abdominal flatulence (p ≤ .05)). Enhanced mobilisation was achieved, but no differences were observed in length of stay or severity of complications. Conclusions: It is essential that the paucity of research to assess post-operative physiotherapy interventions within ERAS® cohorts is highlighted. The results of our literature search highlight that there is a role for post-operative physiotherapy in ERAS® pathways. However, without well-conducted RCTs to evaluate procedure-specific interventions, the optimal type, timing, and dose will not be found and the potential for improving patient functional recovery will be limited.

The data on this page was last updated at 04:55 on May 22, 2019.