School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University, Perth, Australia.
Intern Med J. 2013 Apr;43(4):394-401. doi: 10.1111/j.1445-5994.2012.02928.x.
There has been a recent increase in the research available to guide physiotherapy management of patients who require surgical resection for lung cancer. It is unclear whether this evidence has influenced clinical practice.
To describe physiotherapy practice patterns in the preoperative and postoperative management of patients who undergo surgical resection for lung cancer.
Physiotherapists involved in the management of patients who require surgical resection for lung cancer at hospitals across Australia and New Zealand were mailed a purpose-designed questionnaire.
The response rate was 91% (43/47). Prior to surgery, 40% (n = 17) of the respondents indicated that patients were not assessed by a physiotherapist. In most hospitals (n = 39; 91%), patients did not participate in supervised exercise training before surgery. Most commonly, physiotherapy was commenced on the day following surgery (n = 39; 91%), with walking-based exercise being the treatment that was most frequently implemented in all patients (n = 40; 93%). Seventy-two per cent of respondents referred less than 25% of patients to pulmonary rehabilitation on discharge from hospital. Physiotherapy assessment and treatment choices were influenced predominantly by established practice in the hospital and personal experience rather than research findings.
In people who undergo surgical resection for lung cancer, physiotherapy services focused on reducing or preventing postoperative pulmonary complications. Despite recent data suggesting that exercise training is beneficial in this population, our data indicate that referral to pulmonary rehabilitation was uncommon.
指导需要接受肺癌手术切除的患者进行物理治疗管理的研究最近有所增加。目前尚不清楚这些证据是否影响了临床实践。
描述在为肺癌接受手术切除的患者的术前和术后管理中物理治疗的实践模式。
向澳大利亚和新西兰各地医院参与肺癌手术切除患者管理的物理治疗师邮寄了一份专门设计的问卷。
响应率为 91%(43/47)。在手术前,40%(n=17)的受访者表示患者没有接受物理治疗师的评估。在大多数医院(n=39;91%),患者在手术前没有参加监督性锻炼训练。大多数情况下,物理治疗在手术后的第一天开始(n=39;91%),所有患者中最常实施的治疗是基于行走的锻炼(n=40;93%)。72%的受访者出院时将不到 25%的患者转介到肺康复。物理治疗的评估和治疗选择主要受医院既定实践和个人经验的影响,而不是研究结果的影响。
在接受肺癌手术切除的人群中,物理治疗服务侧重于减少或预防术后肺部并发症。尽管最近的数据表明,运动训练对这一人群有益,但我们的数据表明,向肺康复的转介并不常见。