Comparative efficacy of two physiotherapy approaches in restoring functional performance in individuals after abdominal surgery: a clinical controlled study

Background: Abdominal surgery leads to reduction in respiratory and functional performance post-operatively. Despite the document benefits of the different physiotherapeutic techniques, there is still a wide gap in knowledge on the most effective technique in restoring early functional performance post-operatively.

Objective: This is to compare the efficacy of spirometry and chest-physiotherapy approaches in restoring functional performances in individuals after abdominal surgery.

Methods: This study involved 90 individuals (randomized into 3 groups of 30), who had abdominal surgery in a Nigerian tertiary health institution. Group 1 received chestphysiotherapy; group 2 received incentive-spirometry and group 3 received the combination of both approaches. Functionality was assessed using 10-Meter Walk Test (10MWT) and Barthel Index (BI) while a spirometer was used to assess Forced Vital Capacity (FVC) and Force Expiratory Volume in one-second (FEV1). The BI, FEV1 and FVC were assessed at 24-hour pre-operation, and 24-hour, 3rd-day and 7th-day post-surgery while 10MWT was assessed at 24-hour pre-surgery and 7th-day post-surgery. Data was analysed with Analysis of Variance and Kruskal walis test.

Results: Eighty-seven participants completed the study while 3 died. The groups were matched in all the varaibles at the pre-operation stage. There was drastic reduction in BI, FEV1 and FVC scores at immediate 24-hour post-surgery but increased rapidly throughout the 7-day period. The group who received the combined therapy performed significantly better (p<0.05) in 10MWT at 7th day postoperation. There was no significant diferent (p>0.05) in the BI, FEV1 , FVC and in the development of complications among the groups at the 3rd and 7th days post-operation.

Conclusion: Abdominal surgery cause remarkable decline in functional performances. Early and monitored chest-physiotherapy and spirometry result in rapid improvement in functional performance in individuals within a week of the surgery. However, the combination of the two approaches yields better result in improving functional performance.