Effect of Pre-operative physiotherapy education and Post-operative physiotherapy in children with abdominal surgery

Aim: The aim of the study is to determine the effects of preoperative physiotherapy education (POPE) in preserving lung function in children undergoing open abdominal surgery
Design: The study was an open label, Non randomized controlled trial of two group pretest- posttest design
Study Setting: The study was performed in a pediatric surgery ward, Department of pediatric surgery, tertiary care teaching hospital
Participants: 21 Children with open abdominal surgery were recruited into the study
Methods: After obtaining ethical approval, children were divided into two groups by open label method. Preoperative physiotherapy education is given to the POPE group only. After surgery, Postoperative physiotherapy (POP) was given to both the groups for five days. Follow-up measurements was taken on baseline and on postoperative POD5, Spirometry (FVC, FEV1, FEV1/FVC, PEFR), TUGT, 10mWT, Chest expansion, 6MWT, 9SCT and chest expansion were used as outcome measure.
Results: Independent t-test and Mann whitney u test was used to compare the outcome measures between the groups. Repeated Measure ANOVA, Wilcoxon sign test and paired t-test was used among the groups. Improvement in all the outcome measures accepts 9SCT in POPE group when compared to POPE. While, Statistical significance is noted in the chest expansion at T2 and T4 level and 9SCT. This might be attributed due to small sample size.
Conclusion: Preoperative physiotherapy education along with postoperative physiotherapy might helps in improving pulmonary function and functional capacity after open abdominal surgery

研究目的：本研究旨在明确术前物理治疗教育（preoperative physiotherapy education, POPE）对接受开放式腹部手术（open abdominal surgery）患儿的肺功能保护作用。
研究设计：本研究为开放标签、非随机对照的两组前测-后测设计试验。
研究实施地点：本研究于某三级教学医院（tertiary care teaching hospital）小儿外科病房（pediatric surgery ward）开展。
研究对象：共纳入21名拟行开放式腹部手术的患儿。
研究方法：获得伦理委员会批准后，采用开放标签法将受试者分为两组。仅术前物理治疗教育组（POPE组）接受术前物理治疗教育。术后两组均接受为期5天的术后物理治疗（postoperative physiotherapy, POP）。分别于基线水平及术后第5天（POD5）完成随访评估，以肺功能检查（spirometry，含用力肺活量（Forced Vital Capacity, FVC）、第一秒用力呼气容积（Forced Expiratory Volume in 1 Second, FEV1）、FEV1/FVC比值、峰流速（Peak Expiratory Flow Rate, PEFR））、计时起立行走测试（Timed Up and Go Test, TUGT）、10米步行测试（10-Meter Walk Test, 10mWT）、胸廓扩张度、6分钟步行试验（6-Minute Walk Test, 6MWT）及9秒咳嗽测试（9-Second Cough Test, 9SCT）作为结局指标。
研究结果：采用独立样本t检验（independent t-test）及Mann-Whitney U检验比较组间结局指标差异；组内比较采用重复测量方差分析（Repeated Measure ANOVA）、Wilcoxon符号秩检验（Wilcoxon sign test）及配对t检验（paired t-test）。与对照组相比，POPE组除9秒咳嗽测试（9SCT）外的所有结局指标均得到改善（原文笔误“accepts”应为“except”）；其中T2、T4时点的胸廓扩张度及9SCT检测结果存在统计学显著性差异，该结果可能受样本量较小影响。
研究结论：术前物理治疗教育联合术后物理治疗，或可改善开放式腹部手术患儿术后的肺功能与运动功能储备能力。