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

Burgess, L., Immins, T. and Wainwright, T., 2018. What is the role of post-operative physiotherapy in general surgical Enhanced Recovery after Surgery pathways? European Journal of Physiotherapy. (In Press)

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DOI: 10.1080/21679169.2018.1468813

Abstract

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.

Item Type:Article
ISSN:2167-9169
Additional Information:This is an Accepted Manuscript of an article published by Taylor & Francis Group in European Journal of Physiotherapy on 04/05/2018, available online: http://www.tandfonline.com/10.1080/21679169.2018.1468813
Uncontrolled Keywords:ERAS; rehabilitation; evidence-based physiotherapy/medicine; education; recovery; patient outcomes
Group:Faculty of Health & Social Sciences
ID Code:30679
Deposited By: Unnamed user with email symplectic@symplectic
Deposited On:08 May 2018 11:27
Last Modified:08 May 2018 11:27

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