Addressing the changing rehabilitation needs of patients undergoing thoracic surgery.
Daniel LangerPublished in: Chronic respiratory disease (2021)
The rehabilitation needs of individuals undergoing thoracic surgery are changing, especially as surgical management is increasingly being offered to patients who are at risk of developing functional limitations during and after hospital discharge. In the past rehabilitative management of these patients was frequently limited to specific respiratory physiotherapy interventions in the immediate postoperative setting with the aim to prevent postoperative pulmonary complications. In the past two decades, this focus has shifted toward pulmonary rehabilitation interventions that aim to improve functional status of individuals, both in the pre- and (longer-term) postoperative period. While there is increased interest in (p)rehabilitation interventions the majority of thoracic surgery patients are however currently on their own with respect to progression of their exercise and physical activity regimens after they have been discharged from hospital. There are also no formal guidelines supporting the referral of these patients to outpatient rehabilitation programs. The current evidence regarding rehabilitation interventions initiated before, during, and after the hospitalization period will be briefly reviewed with special focus on patients undergoing surgery for lung cancer treatment and patients undergoing lung transplantation. More research will be necessary in the coming years to modify or change clinical rehabilitation practice beyond the acute admission phase in patients undergoing thoracic surgery. Tele rehabilitation or web-based activity counseling programs might also be interesting emerging alternatives in the (long-term) postoperative rehabilitative treatment of these patients.
Keyphrases
- patients undergoing
- end stage renal disease
- physical activity
- ejection fraction
- newly diagnosed
- thoracic surgery
- chronic kidney disease
- peritoneal dialysis
- public health
- patient reported outcomes
- emergency department
- body mass index
- quality improvement
- depressive symptoms
- risk factors
- atrial fibrillation
- body composition
- electronic health record
- percutaneous coronary intervention
- men who have sex with men
- patient reported
- coronary artery bypass