Research Update: Pre-Operative Physiotherapy Study

14 May 2014

A physiotherapy research team at the Launceston General Hospital is undertaking work on a two year research trial that aims to improve the outcome of patients who have undergone major abdominal surgery.

Through a research grant from the Clifford Craig Medical Research Trust, cardiorespiratory supervisor physiotherapist, Ms Ianthe Boden, and her team will determine if pre-operative physiotherapy can prevent lung infections after major abdominal surgery.

Chest infections can occur in as many as 1 out of every 2 patients after they have had major bowel, stomach, liver or kidney surgery. This is serious and costly. Chest infections dramatically increase the risk of death following surgery, and the average length of time spent in hospital is doubled.

Studies have shown that getting up, and out of bed, and walking as early as possible after surgery with a Physiotherapist reduces this chance of getting a chest infection down to as low as 1 in 20. Unfortunately, the results of these studies are rather clouded because they have also included time spent with a Physiotherapist before the operation on learning how to do breathing exercises and how to get going again soon after the operation.

So, it is really hard to say for certain if this significant reduction in chest infections is down, not just to the amount of walking a patient does after the operation, but also to the level of education they received before the operation. No clinical trial to this point has specifically looked at how effective this type of pre-operative education is, in its own right, in reducing the risk of a chest infection after an operation.

The LGH trial will provide education and training from a Physiotherapist to half of the patients about to undergo major abdominal surgery. The other half will get just get a pamphlet covering the same sort of information. All patients will get a thorough and standardised early walking program following their surgery.

The trial will compare these two groups, totalling 400 participants, and see if there is any difference in rates of chest infections, how long they stay in hospital, how well they recover after the operation and how long they take to be able to resume normal activity.

The result of this trial will assist in determining the wisest and most cost effective way to allocate Physiotherapy services to people having a major abdominal operation and assist them in recovering from their operation as quickly as possible.

Since the initial project commenced, it has now expanded to include a further two studies (1) to see if extra rehabilitation from a physiotherapist immediately following emergency abdominal surgery reduces complications and improves recovery following their operation, and (2) an observational trial into current rates of complications in patients that undergo lower abdominal and laparoscopic surgery.