title: Perioperative physiotherapy in patients undergoing lung cancer resection.
abstract: Physiotherapy is considered an important component of the perioperative period of lung resection surgery. A systematic review was conducted to assess evidence for the effectiveness of different physiotherapy interventions in patients undergoing lung cancer resection surgery. Online literature databases [Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, SCOPUS, PEDro and CINAHL] were searched up until June 2013. Studies were included if they were randomized controlled trials, compared 2 or more perioperative physiotherapy interventions or compared one intervention with no intervention, included only patients undergoing pulmonary resection for lung cancer and assessed at least 2 or more of the following variables: functional capacity parameters, postoperative pulmonary complications or length of hospital stay. Reviews and meta-analyses were excluded. Eight studies were selected for inclusion in this review. They included a total of 599 patients. Seven of the studies were identified as having a low risk of bias. Two studies assessed preoperative interventions, 4 postoperative interventions and the remaining 2 investigated the efficacy of interventions that were started preoperatively and then continued after surgery. The substantial heterogeneity in the interventions across the studies meant that it was not possible to conduct a meta-analysis. The most important finding of this systematic review is that presurgical interventions based on moderate-intense aerobic exercise in patients undergoing lung resection for lung cancer improve functional capacity and reduce postoperative morbidity, whereas interventions performed only during the postoperative period do not seem to reduce postoperative pulmonary complications or length of hospital stay. Nevertheless, no firm conclusions can be drawn because of the heterogeneity of the studies included. Further research into the efficacy and effectiveness of perioperative respiratory physiotherapy in this patient population is needed.
authors.affiliation: Department of Physiology, University of the Basque Country, Leioa, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Rodriguez-Larrad
authors.affiliation: Department of Physiology, University of the Basque Country, Leioa, Spain.
authors.forename: Ion
authors.initials: I
authors.lastname: Lascurain-Aguirrebena
authors.affiliation: Department of Preventive Medicine and Public Health, Faculty of Pharmacy, University of the Basque Country, Vitoria-Gasteiz, Spain.
authors.forename: Luis Carlos
authors.initials: LC
authors.lastname: Abecia-Inchaurregui
authors.affiliation: Institute of Biomedicine (IBIOMED), University of León, León, Spain Present address: Visiting Researcher, University of the Basque Country, Leioa, Spain dr.seco.jesus@gmail.com.
authors.forename: Jesús
authors.initials: J
authors.lastname: Seco
mesh_terms: D006801:Humans; D007902:Length of Stay; D008168:Lung / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008175:Lung Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D019990:Perioperative Care; D026741:Physical Therapy Modalities / Q000009:adverse effects; D011013:Pneumonectomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000503:physiopathology / Q000517:prevention & control; D020127:Recovery of Function; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Lung cancer; Perioperative care; Physiotherapy; Pulmonary rehabilitation