Physiotherapy management of patients undergoing thoracotomy procedure: A survey of current practice in Gauteng.
Liezel Schwellnus, Ronel Roos, Vaneshveri Naidoo
PMID 30135901WHAT IT FOUND
Among surveyed physiotherapists who treated open thoracotomy patients, most gave care during hospital stay, with less preoperative and post-discharge contact.
Common treatments were breathing, coughing and early mobilisation; pain techniques were used infrequently.
Key findings
01Of 141 respondents, 116 (82.3%) treated patients during hospital stay, 65 (46.1%) did preoperative management and 46 (32.6%) treated patients after discharge.
02Among 85 respondents who specified inpatient interventions, deep breathing was used by 97.6% (n=83), coughing by 95.3% (n=81), early mobilisation by 95.3% (n=81), upper limb mobility by 91.8% (n=78), chest wall vibrations by 88.2% (n=75) and trunk mobility by 85.9% (n=73); TENS was used by 12.9% (n=11).
03Of 46 respondents who treated patients after discharge, the most common techniques were upper limb mobility (65.2%, n=30), soft tissue mobility (63.0%, n=29), general exercises (63.0%, n=29), soft tissue pain reduction (60.9%, n=28), trunk mobility (58.7%, n=27) and progressive walking (56.5%, n=26); electrotherapy for pain was used by 30.3% (n=14).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample was limited to physiotherapists registered with the South African Society of Physiotherapy in Gauteng, so it does not describe practice elsewhere. Only 323 of 1389 invited physiotherapists responded, and 141 were analysed, so the results may not represent all physiotherapists in the province. Most respondents worked in the private sector, so public-sector practice is not well captured. The study reports self-reported treatment patterns, not patient outcomes, so it cannot show whether these practices helped patients. Not all respondents who treated patients during hospital stay specified their interventions, so the intervention percentages are based on 85 of 116. The survey did not separate elective from emergency thoracotomy, so differences in trauma-related care may be hidden.
The easy way to misread this
Do not read the high reported use of deep breathing, coughing and early mobilisation as proof that these treatments improve patient outcomes. This was a self-reported survey of physiotherapy practice, not a trial of patient results, and it had a poor response rate and mainly private-sector respondents.