Bariatric Surgery Candidate Clinical Trial
Official title:
The Effect of Chest Physiotherapy After Bariatric Surgery on Pulmonary Functions, Functional Capacity and Quality of Life
The aim of this study was to investigate the effect of chest physiotherapy applied to patients undergoing bariatric surgery on pulmonary functions, dyspnea levels, functional capacity and quality of life.
This randomized, controlled trial, was designed, conducted, and reported in accordance with
the standards of The CONSORT (Consolidated Standards of Reporting Trials) Statement. The
patients were randomised and divided into two groups each comprising 74 patients. Chest
physiotherapy and mobilisation was applied to the patients in the first group, and only
mobilisation was applied to the patients in the second group. The treatment of the patients
was started on the first postoperative day and continued until the postoperative 4th day.
Chest physiotherapy and mobilization were applied twice a day, 8 times in total. The
following parameters were evaluated preoperative and postoperative:arterial blood gas, oxygen
saturation, respiratory function test for pulmonary functions, pulmonary artery pressure for
pulmonary hypertansion, Borg dyspnea score for severity of dyspnoea, 6-minute walk test for
functional capacity, Nottingham health profile for quality of life.
Chest physiotherapy consisted of postural drainage (30-45 degree eleve), breathing exercises
(deep breathing, diaphragm breathing, active breathing techniques cycle) and coughing
techniques (huffing, controlled coughing, manual assisted coughing). In the chest
physiotherapy program, diaphragmatic respiration, constrictive lip respiration, segmental
respiration, incentive spirometry and coughing were performed on the 1st postoperative day.
All respiratory exercises were repeated twice a day and percussion was added on the 2nd
postoperative day. All respiratory exercises and percussion were repeated 2 times a day until
the discharge of the post op day 4 until discharge, and the work with incentive spirometry
was removed per hour. Patients were mobilized as early as possible by the physiotherapist.
The patients in both groups were instructed to sit out of bed and stand up on the first
postoperative day, walk 45 m in the corridor on the second day, walk freely (approximately
150-300 m) on the third and the fourth days.
All operations were laparoscopic, sleeve gastrectomy or Roux-en Y gastric bypass (21).
Routine anesthesia was performed with desflurane and remifentanil. In all procedures,
patients were treated with the split upward position (French position) and a semi-reclining
position (anti-Trendelenburg position). All patients received prophylaxis against deep vein
thrombosis for 2 weeks with pneumatic compression stocking and subcutaneous low molecular
weight heparin. Perioperative antibiotics (cefazolin 2 g) were also routinely administered.
The patients were discharged on the fourth postoperative day.
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