title: Chest physiotherapy and breathing exercises for cardiac surgery patients in Sweden--a national survey of practice.
abstract: BACKGROUND
  Various chest physiotherapy techniques are recommended after cardiac surgery around the world. There is limited published data on what breathing exercises actually are recommended to patients after surgery in Europe. The aim of this national survey was to establish the current practice of chest physiotherapy and breathing exercises for adult patients following cardiac surgery in Sweden.
  
  
  METHODS
  A postal questionnaire was sent to a total population sample of 33 Swedish physiotherapists working at the departments of cardiothoracic surgery in December 2007 and January 2008.
  
  
  RESULTS
  In total, 29 replies (88%) were received. Seven male and twenty two female physiotherapists completed the questionnaire. All physiotherapists instructed, on a regular basis, the cardiac surgery patients to perform post-operative breathing exercises. Positive expiratory pressure (PEP) breathing was routinely used as the first choice for treatment by 22 (83%) of the physiotherapists. Expiratory pressures used varied between 2 and 20 cm H2O. Recommended frequency and duration of the exercises varied from 4 to 30 breaths hourly during the daytime in the first post-operative days. All physiotherapists provided coughing support to the patients. Recommendations to continue breathing exercises after discharge varied from not at all up to 3 months after surgery.
  
  
  CONCLUSIONS
  Breathing exercises are regularly prescribed during the initial post-operative days after cardiac surgery in Sweden. Hourly deep breathing exercises performed with or without a PEP device were reported to be first choice treatments during the hospital stay. Instructions concerning how long patients should continue the exercises after discharge varied notably.
authors.affiliation: Department of Cardiothoracic Surgery, Orebro University Hospital, Orebro, Sweden. elisabeth.westerdahl@orebroll.se
authors.forename: E
authors.initials: E
authors.lastname: Westerdahl
authors.forename: M Fagevik
authors.initials: MF
authors.lastname: Olsén
mesh_terms: D000328:Adult; D001945:Breathing Exercises; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011175:Positive-Pressure Respiration; D011183:Postoperative Complications / Q000517:prevention & control*; D011184:Postoperative Period; D011795:Surveys and Questionnaires; D013548:Sweden