Effect of Digital Physiotherapy Practice on Pulmonary Function, Muscle Strength, Quality of Life After Thoracic Surgery

Official title

The Effect of Digital Physiotherapy Practices on Pulmonary Functions, Respiratory Muscle Strength, Functional Capacity, Upper Extremity Peripheral Muscle Strength and Quality of Life in Patients Undergoing Thoracic Surgery

Overview

Thoracic surgery is the primary intervention used in the treatment of diseases affecting the lungs, pleura, chest wall, and mediastinum. Postoperative changes occur in both lung functions and clinical symptoms due to the procedure itself and patient-related factors. After thoracic surgery, patients often experience reduced exercise tolerance and impaired respiratory functions, negatively affecting their participation in daily activities, functional levels, and quality of life. In open thoracotomies, the incision site, severed muscles, and the size of the incision can impact upper extremity and trunk functions. The aim of this study is to investigate the effects of physiotherapy applied through digital methods on respiratory functions, respiratory muscle strength, functional capacity, upper extremity muscle strength, and quality of life in patients who have undergone thoracic surgery.

Detailed description

Thoracic surgery is a primary intervention used in the treatment of diseases of the lungs, pleura, chest wall, and mediastinum. Following surgery, changes in lung function and associated clinical symptoms may occur due to both the surgical procedure itself and patient-specific factors, and these may present intraoperatively and/or postoperatively. These changes are primarily restrictive in nature and may include a characteristic reduction in lung volume, a decrease in functional residual capacity that may lead to atelectasis, slowed mucociliary clearance, gas exchange abnormalities, and especially reduced chest expansion on the operated side. Additionally, problems in surfactant production and diaphragmatic dysfunction may also arise. Furthermore, the use of surgical drains, the nature of the surgical procedure, the integrity of the remaining lung tissue after resection, and the limitations caused by enforced immobility can all contribute to the development of various postoperative complications. Preventing and/or managing these postoperative complications is essential for enabling the patient to return to functional life, reducing long-term healthcare utilization, and improving survival rates. For this reason, pulmonary rehabilitation is indicated after thoracic surgeries. One of the methods of delivering rehabilitation is telerehabilitation, which allows patients to access therapy remotely. In this study, however, the term Digital Physiotherapy, which is a more current and comprehensive term recommended by World Physiotherapy, will be used. In the literature review, it was observed that most postoperative studies following thoracic surgery focus on the in-hospital period, while studies conducted after discharge are usually of short duration. The aim of this study is to examine the effects of long-term physiotherapy delivered through digital methods following thoracic surgery.

Interventions

• Other Exercise
  Exercise sessions will begin with flexibility exercises targeting the shoulder and neck regions. This will be followed by breathing exercises utilizing fundamental respiratory techniques. Extremity exercises will include movements focused on the upper extremities and trunk, with progression applied according to a pre-established plan. Each session will conclude with cool-down exercises. Additionally, patients will be encouraged to engage in regular walking on a weekly basis.
• Other Standard care
  Patients will receive education regarding the critical aspects to consider after hospital discharge. Standard postoperative care protocols will be implemented.

Primary outcome measures

• Forced vital capacity (FVC) [Time frame: 12 weeks]
• Forced expiratory volume in 1 second (FEV1) [Time frame: 12 weeks]
• Tiffeneau ratio (FEV1/FVC) [Time frame: 12 weeks]
• Peak expiratory flow (PEF) [Time frame: 12 weeks]
• Respiratory Muscle Strength [Time frame: 12 weeks]
• Functional Capacity [Time frame: 12 weeks]
• Upper Extremity Peripheral Muscle Strength [Time frame: 12 weeks]
• Health Related Quality of Life [Time frame: 12 weeks]

Secondary outcome measures (5)

• Shoulder Joint Range of Motion Measurement [Time frame: 12 weeks]
• Trunk Lateral Flexion Flexibility [Time frame: 12 weeks]
• Chest Expansion [Time frame: 12 weeks]
• Shoulder Pain [Time frame: 12 weeks]
• Sleep [Time frame: 12 weeks]

Eligibility criteria

Inclusion criteria

• Patients who underwent open thoracotomy
• Agreement to participate in the study
• Being between the ages of 18-75
• Having an internet connection at home and being able to participate in video-conference sessions via desktop-laptop computers, smartphones, electronic tablets, etc.

Exclusion criteria

• Pneumonectomy surgeries
• Having a cardiac, orthopedic, neurological or systemic disease that would prevent exercise
• Having mental, communication or behavioral disorders that would cause problems in understanding commands and questions or performing exercises.
• Participating in a pulmonary rehabilitation program before surgery
• Having been hospitalized for any pulmonary disease during the study

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Center list to be confirmed — check the primary protocol.

Identifiers

NCT: NCT07133672 · BVUaysegul001

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗