Prevention of postoperative pulmonary complications through respiratory rehabilitation: a controlled clinical study

Arch Phys Med Rehabil. 1998 Jan;79(1):5-9. doi: 10.1016/s0003-9993(98)90198-8.


Objective: To investigate the efficacy of respiratory rehabilitation in preventing postoperative pulmonary complications (PPC) and to define which patients can benefit.

Design: A randomized clinical trial.

Setting: A public hospital.

Patients: Eighty-one patients who had upper abdominal surgery were distributed into two homogeneous groups: control (n = 41) and rehabilitation (n = 40).

Intervention: Breathing exercises in the rehabilitation group.

Main outcome measures: Preoperative and postoperative clinical evaluation, spirometry, arterial gasometry, and simple chest X-rays.

Results: The incidence of PPC was 7.5% in the rehabilitation group and 19.5% in the control group; the control group also had more radiologic alterations (p = .01). Stratified PPC analysis did not reveal significant differences between groups. However, high- and moderate-risk patients in the rehabilitation group had fewer PPC. Multivariate analysis showed a greater PPC risk associated with pulmonary history (p = .02) and duration of surgery longer than 120 min (p = .03), while rehabilitation exerted a protective effect (p = .06). Significant postoperative decreases in pulmonary volumes and arterial gas values were recorded in both groups, without significant differences.

Conclusions: Respiratory rehabilitation protects against PPC and is more effective in moderate- and high-risk patients, but does not affect surgery-induced functional alterations.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Gas Analysis
  • Bronchitis / prevention & control*
  • Bronchitis / rehabilitation
  • Female
  • Forced Expiratory Volume
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pneumonia / prevention & control*
  • Pneumonia / rehabilitation
  • Postoperative Complications / prevention & control*
  • Postoperative Complications / rehabilitation
  • Pulmonary Atelectasis / prevention & control*
  • Pulmonary Atelectasis / rehabilitation
  • Respiratory Therapy / methods*
  • Risk Factors
  • Time Factors
  • Vital Capacity