EFFICACY OF CHEST-PHYSIOTHERAPY AND INCENTIVE-SPIROMETRY IN IMPROVING CARDIOVASCULAR AND PULMONARY FUNCTIONAL PERFORMANCES IN INDIVIDUALS POST-THORACO-ABDOMINAL SURGERY: A RANDOMISED COMTROLLED STUDY

Abstract

Objective: To compare the efficacy of selected chest-physiotherapy and incentive-spirometry in improving cardiovascular and pulmonary functions and preventing complications in individuals who had thoracic and/or abdominal surgery. Methodology: This study involved 90 individuals (randomized into three groups of thirty), who had thoracic and/or abdominal surgery in a Nigeria tertiary health institution. In addition to early mobilization, the first group was managed with selected chest-physiotherapy; second group with incentive-spirometry and third group using the combination the two procedures. Their cardiovascular (Systolic, Diastolic, Mean Arterial and Pulse pressures and Oxygen-haemoglobin saturation) and pulmonary (Forced Vital Capacity and Expiratory Volumeone-second) functions were assessed at 24-hour pre-operation, and 24-hour, third-day and seventh-day post-operation. Compliance on the use of incentive-spirometer was assessed using compliance scale. Data was analysis with Analysis of Variance and Kruskal-Wallis test. Results: Eighty-seven participants completed the study (3 died) with only six had post-operative complications. More were diagnosed of uterine fibroid (38.8%), operated under general anaesthesia (74.5%), and had exploratory laparotomy (35.6%) with midline incision (54.5%). The compliance rate of the participants was 100%. There was significant reduction in cardiovascular and pulmonary functions between 24-hour pre-operation and 24-hour post-operation but there was significant increase in the parameters between 24-hour and third-day and between third-day and seventh-day post-operation in all the groups. Those who received combined therapy performed clinically but not statistically better in all the parameters and with no record of any complication. Conclusion: Thoracic and/or abdominal surgery has negative impact on the cardiovascular and pulmonary functional performances. Either selected chest-physiotherapy techniques or incentive-spirometry is effective in improving cardiovascular and pulmonary functions and prevent complications in individual who had had a thoracic and/or abdominal surgery but the combination of both techniques in clinically more efficacious.