The Effect of Chest Physiotherapy After Bariatric Surgery
Condition: Bariatric Surgery Candidate; Pulmonary Disease
MeSH terms: Lung Diseases
Study type: Interventional

Summary: 
      The aim of this study was to investigate the effect of chest physiotherapy applied to
      patients undergoing bariatric surgery on pulmonary functions, dyspnea levels, functional
      capacity and quality of life.
    

Detailed description: 
      This randomized, controlled trial, was designed, conducted, and reported in accordance with
      the standards of The CONSORT (Consolidated Standards of Reporting Trials) Statement. The
      patients were randomised and divided into two groups each comprising 74 patients. Chest
      physiotherapy and mobilisation was applied to the patients in the first group, and only
      mobilisation was applied to the patients in the second group. The treatment of the patients
      was started on the first postoperative day and continued until the postoperative 4th day.
      Chest physiotherapy and mobilization were applied twice a day, 8 times in total. The
      following parameters were evaluated preoperative and postoperative:arterial blood gas, oxygen
      saturation, respiratory function test for pulmonary functions, pulmonary artery pressure for
      pulmonary hypertansion, Borg dyspnea score for severity of dyspnoea, 6-minute walk test for
      functional capacity, Nottingham health profile for quality of life.

      Chest physiotherapy consisted of postural drainage (30-45 degree eleve), breathing exercises
      (deep breathing, diaphragm breathing, active breathing techniques cycle) and coughing
      techniques (huffing, controlled coughing, manual assisted coughing). In the chest
      physiotherapy program, diaphragmatic respiration, constrictive lip respiration, segmental
      respiration, incentive spirometry and coughing were performed on the 1st postoperative day.
      All respiratory exercises were repeated twice a day and percussion was added on the 2nd
      postoperative day. All respiratory exercises and percussion were repeated 2 times a day until
      the discharge of the post op day 4 until discharge, and the work with incentive spirometry
      was removed per hour. Patients were mobilized as early as possible by the physiotherapist.
      The patients in both groups were instructed to sit out of bed and stand up on the first
      postoperative day, walk 45 m in the corridor on the second day, walk freely (approximately
      150-300 m) on the third and the fourth days.

      All operations were laparoscopic, sleeve gastrectomy or Roux-en Y gastric bypass (21).
      Routine anesthesia was performed with desflurane and remifentanil. In all procedures,
      patients were treated with the split upward position (French position) and a semi-reclining
      position (anti-Trendelenburg position). All patients received prophylaxis against deep vein
      thrombosis for 2 weeks with pneumatic compression stocking and subcutaneous low molecular
      weight heparin. Perioperative antibiotics (cefazolin 2 g) were also routinely administered.
      The patients were discharged on the fourth postoperative day.
    

Intervention name(s): Treatment; Group 2
Intervention type(s): Other; Other
Intervention description(s): Chest physiotherapy and mobilization were applied twice a day, 8 times in total.; Only mobilization was applied twice a day, 8 times in total.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The patients were randomised using randomisation software and divided into two groups each comprising 74 patients. Chest physiotherapy and mobilisation was applied to the patients in the first group, and only mobilisation was applied to the patients in the second group.
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Bariatric surgery; Chest physiotherapy; Pulmonary functions; Quality of life