title: A survey of physiotherapeutic provision for patients undergoing thoracic surgery in the U.K.
abstract: OBJECTIVE
  Evaluation of physiotherapeutic provision for patients undergoing open thoracotomy and lung surgery in the U.K. Timing of physiotherapy, modalities used and factors influencing practice were also investigated.
  
  
  METHODS
  Survey.
  
  
  METHODS
  Tertiary centres performing thoracic surgery.
  
  
  METHODS
  Forty U.K. centres were identified, and senior physiotherapists were invited to participate.
  
  
  METHODS
  A postal survey was distributed to identified centres in August 2008, with further follow-up of non-responders. This was adapted from a similar study conducted in Australia and New Zealand.
  
  
  RESULTS
  Thirty-one responses were received (78%). Pre-operative physiotherapy was provided by 87% of respondents: 10% provided physiotherapy for all patients and 77% only provided physiotherapy for high-risk patients. Pre-operative pulmonary rehabilitation was reported in 13% of centres. Postoperative physiotherapeutic assessment was undertaken routinely by 97% of respondents: 81% provided physiotherapy to all patients, and 16% only provided physiotherapy when a specific problem was identified. The treatments given were relatively standardised. The provision of physiotherapy following hospital discharge was generally very sparse.
  
  
  CONCLUSIONS
  This study provides a guide for physiotherapists working with patients undergoing thoracic surgery to use to compare their current practices. Postoperative physiotherapy is provided extensively to UK patients undergoing open thoracotomy. However, pre-operative provision is more variable and is mainly provided for high-risk patients. Despite the subsequent publication of pre- and postoperative pulmonary rehabilitation studies, UK physiotherapy practice remained similar to that reported in Australia and New Zealand. Further research in this field is necessary to investigate the role of pre-operative physiotherapy, the role of pre- and postoperative pulmonary rehabilitation, and the effectiveness of routine postoperative physiotherapy.
authors.affiliation: Department of Thoracic Surgery, Heart of England NHS Foundation Trust, Birmingham Heartlands Hospital, Birmingham, UK. paulaagostini@aol.com
authors.forename: P
authors.initials: P
authors.lastname: Agostini
authors.forename: J
authors.initials: J
authors.lastname: Reeve
authors.forename: S
authors.initials: S
authors.lastname: Dromard
authors.forename: S
authors.initials: S
authors.lastname: Singh
authors.forename: R S
authors.initials: RS
authors.lastname: Steyn
authors.forename: B
authors.initials: B
authors.lastname: Naidu
mesh_terms: D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000601:surgery*; D008297:Male; D026741:Physical Therapy Modalities; D011183:Postoperative Complications / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D013908:Thoracotomy / Q000534:rehabilitation*; D006113:United Kingdom