Pre-operative physiotherapy for elderly patients undergoing abdominal surgery.
Rozelle Labuschagne, Ronel Roos
PMID 36262215WHAT IT FOUND
No significant differences emerged between groups for any clinical outcome.
The intervention group had fewer postoperative pulmonary complications and walked further when first mobilising, but these were secondary observations in a 12-person pilot. Do not change practice based on this.
Key findings
01Clinical outcomes including length of stay, postoperative pulmonary complications and time to first mobilisation were not significantly different between the control and intervention groups.
02At hospital discharge and at follow-up, physical function measures showed no significant difference between groups.
03The intervention group had fewer participants with signs of postoperative pulmonary complications and walked further during first mobilisation, but these were noted as clinically important without statistical significance.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study included only 12 participants, making it a pilot designed to inform a larger trial rather than to test efficacy. Participants were referred by surgeons and were generally fit rather than frail, so findings may not apply to the patients who might benefit most from prehabilitation. The time available for prehabilitation was limited to a maximum of one week due to short surgical wait times, which is less than the two weeks suggested as a minimum for engagement. All participants received routine physiotherapy during hospital stay, and the study did not control for variability in how individual therapists delivered that care. Recruitment was hampered by low referral rates and high non-consent, raising questions about the feasibility of this specific service model.
Declared interests
The paper does not report funding sources or conflicts of interest.
The easy way to misread this
Do not interpret the fewer pulmonary complications and greater walking distance in the intervention group as evidence that this prehabilitation programme works. These differences were not statistically significant in a trial of only 12 people, and the study was powered only to assess feasibility.