A randomized clinical trial in improving pulmonary function and functional capacity in pediatric open abdominal surgery

Abstract

PurposePulmonary function and functional capacity gets compromised and reduced after open abdominal surgery. We assessed whether Preoperative physiotherapy education (POPE) along with postoperative physiotherapy (POP) preserve pulmonary function and functional capacity after open abdominal surgery among Pediatric population. Hence, the goal of this study was to determine the effectiveness of POPE combined with POP against the standard treatment care of, Postoperative physiotherapy (POP) only in improving pulmonary function and functional capacity in pediatric open abdominal surgery. MethodsTwenty one children aged, 5–17 years old undergoing the open abdominal surgery were randomized to POPE and POP group (Intervention arm 1) and Postoperative physiotherapy group (POP) only group (Intervention arm 2). Primary outcome measure was pulmonary function measured by computerized spirometry. Six minute walk test (6MWT), Ten meter walk test (10mWT), Timed up and go test (TUGT) and Nine stair climbing test (9SCT) were used as secondary outcome measures to measure functional capacity along with chest expansion.Pulmonary function measured by spirometery, 10mWT, TUG and chest expansion were measured 1 day before undergoing abdominal surgery (Pre-OP), post-operative day 1 (POD1) and post-operative day 5 (POD5) while 6MWT and 9SCT were measured only at POD1 and POD5. ResultsEighteen children who were undergoing open abdominal surgery completed this trial.No statistical difference were noted in Spirometric parameters from Pre-OP to POD5 in both the groups, they are almost approximate to preoperative values, but from POD1 to POD5, statistical difference were noted in all the Spirometric parameters in Intervention arm 1 as compared to Intervention arm 2. Statistical significant improvement (p < 0.05) were noted in TUGT, 10mWT, 9SCT from Pre-OP to POD5 and from POD1 to POD5 also in Intervention arm 1 as compared to Intervention arm 2. ConclusionThere is sufficient evidence to confirm that POPE combined with POP might improve pulmonary function and functional capacity in children undergoing open abdominal surgery. Type of studyTreatment study. Level of evidenceLevel I.