title: A postoperative shoulder exercise program improves function and decreases pain following open thoracotomy: a randomised trial.
abstract: OBJECTIVE
  Does a postoperative physiotherapy exercise program incorporating shoulder exercises improve shoulder function, pain, range of motion, muscle strength, and health-related quality of life in patients undergoing elective pulmonary resection via open thoracotomy?
  
  
  METHODS
  Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis.
  
  
  METHODS
  76 patients who underwent pulmonary resection via open thoracotomy.
  
  
  METHODS
  All participants received standard medical and nursing care involving a clinical pathway. The experimental group also received physiotherapy interventions that included daily supervised, progressive exercises until discharge and a postoperative exercise booklet on discharge.
  
  
  METHODS
  Preoperatively and up to 3 months postoperatively pain was measured with a numerical rating scale, shoulder function with the Shoulder Pain and Disability Index, and quality of life with the Short Form-36. Shoulder range of motion and muscle strength were measured in a subgroup.
  
  
  RESULTS
  The experimental group had 1.3 units (95% CI 0.3 to 2.2) less shoulder pain (scored /10) and 2.2 units (95% CI 0.2 to 4.3) less total pain (scored /30) at discharge, and 7.6% (95% CI 1.7 to 13.6) better function at 3 months. The Short Form-36 physical component score was 4.8 points (95% CI -0.3 to 10.0) better for the experimental group than the control group at 3 months. Differences between groups in all range of motion and strength measures were small and statistically non-significant.
  
  
  CONCLUSIONS
  A physiotherapist-directed postoperative exercise program resulted in significant benefits in pain and shoulder function over usual care for patients following open thoracotomy.
  
  
  BACKGROUND
  ANZCTRN 12605000201673.
authors.affiliation: AUT University, New Zealand. julie.reeve@aut.ac.nz
authors.forename: Julie
authors.initials: J
authors.lastname: Reeve
authors.forename: Kathy
authors.initials: K
authors.lastname: Stiller
authors.forename: Kristine
authors.initials: K
authors.lastname: Nicol
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: McPherson
authors.forename: Paul
authors.initials: P
authors.lastname: Birch
authors.forename: Ian R
authors.initials: IR
authors.lastname: Gordon
authors.forename: Linda
authors.initials: L
authors.lastname: Denehy
mesh_terms: D000368:Aged; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000601:surgery; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D010149:Postoperative Pain / Q000209:etiology* / Q000517:prevention & control*; D026741:Physical Therapy Modalities; D011788:Quality of Life; D016059:Range of Motion, Articular / Q000502:physiology; D012785:Shoulder Joint / Q000502:physiology*; D016037:Single-Blind Method; D013908:Thoracotomy / Q000009:adverse effects*