Physiotherapy management of patients with trunk trauma: A state-of-the-art review.
Helena van Aswegen
PMID 32671276WHAT IT FOUND
Small studies support early physiotherapy for adults with chest trauma: mobilisation, breathing exercises, coughing and multidisciplinary pathways may shorten hospital stay.
Evidence is limited, and post-discharge rehabilitation is rarely reported.
Key findings
01After penetrating chest injury and intercostal drain insertion, immediate physiotherapy shortened haemothorax drainage and hospital stay.
02Multidisciplinary care bundles that include respiratory support, analgesia, complication prevention and surgical fixation reduce morbidity and mortality, but the contribution of physiotherapy alone cannot be separated.
03Unresolved pain, reduced physical and respiratory function and chest wall deformity persisted at 24 months after discharge, and only 8% of surveyed participants provided post-discharge rehabilitation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was a non-systematic narrative review, not a systematic review or meta-analysis. Only 14 articles were included, and many were small trials, surveys or expert opinion, so certainty is low. Most evidence involved chest trauma, especially penetrating stab injuries, so it does not tell you how to manage blunt or penetrating abdominal trauma. Care bundles combined physiotherapy with respiratory support, analgesia, complication prevention and surgical fixation, so you cannot tell how much physiotherapy alone contributed. Long-term outcomes and post-discharge rehabilitation were poorly described; only 8% of surveyed participants reported providing post-discharge rehabilitation. Outcome measures were used inconsistently in practice, making it hard to compare patients or judge progress.
The easy way to misread this
Do not read the shorter hospital stay as proof that physiotherapy alone caused it. In the care-bundle studies, physiotherapy was delivered alongside respiratory support, analgesia, complication prevention and surgical fixation, and the review does not isolate the physiotherapy component.