ABSTRACT
OBJECTIVE: To investigate the effects of a physiotherapy protocol on patients with pleural effusion. DESIGN: Randomized controlled trial. SETTING: University hospital. PARTICIPANTS: A total of 104 consecutive inpatients with a medical diagnosis of pleural effusion. INTERVENTION: Patients were randomly allocated to a control group receiving standard treatment (medical treatment and drainage) or an intervention group treated with physiotherapy added to standard treatment. The physiotherapy programme included deep breathing exercises, mobilizations and incentive spirometry. MAIN OUTCOME MEASURES: Spirometric predicted values and chest radiographs were measured before treatment and at discharge and the length of hospital stay was recorded. Assessors were blinded to the intervention. RESULTS: A comparative analysis showed a significant improvement of spirometric parameters in the intervention group; pre-to-post hospitalization predicted values showed significant changes in vital capacity (73.1 ± 12.6% to 72.13 ± 13.7 %, P<0.001 ), forced expiratory volume in first second (72.13 ± 13.7% to 78.98 ± 16.9%, P<0.001) and forced expiratory flow at 25-75 % (64.8 ± 35.1% to 76.78 ± 35.3%, P=0.198) compared to the control group that showed no significant changes across treatment. The radiographic findings showed better scores on the affected side of the thorax at discharge in the physiotherapy group. Length of hospital stay was also significantly (P=0.014) shorter in the intervention group (26.7 ± 8.8 days) compared to the control group (38.6 ± 10.7 days). CONCLUSIONS: A physiotherapy programme added to standard treatment improves the spirometric parameters and the radiological findings and reduces the hospital stay in patients with a pleural effusion.
Subject(s)
Breathing Exercises/methods , Exercise Therapy/methods , Physical Therapy Modalities/organization & administration , Pleural Effusion/rehabilitation , Adult , Combined Modality Therapy , Drainage/methods , Female , Follow-Up Studies , Hospitals, University , Humans , Length of Stay , Male , Middle Aged , Pleural Effusion/diagnosis , Pleural Effusion/therapy , Program Evaluation , Radiography, Thoracic/methods , Reference Values , Risk Assessment , Severity of Illness Index , Spain , Spirometry/methods , Treatment OutcomeABSTRACT
Introducción. El fisioterapeuta emplea, dentro de sus herramientas de valoración, aquellas destinadas a la medición de la función pulmonar. Todos los factores que afectan la función pulmonar deben ser conocidos de manera exhaustiva por el fisioterapeuta. Este trabajo pretende esclarecer aquellos factores, de carácter físico, que condicionan la función pulmonar. Objetivo. Revisar la bibliografía disponible que relacione los factores físicos que influyen en la función pulmonar. Estrategia de búsqueda. Revisión bibliográfica sistemática en las bases de datos: CINAHL, ScienceDirect, Ovid, Scopus y PubMed. Con antigüedad inferior a 25 años. Síntesis de resultados. Se obtuvo un número total de 90 artículos. Los autores han reconocido que entre los factores físicos de la función pulmonar se encuentran la edad, el sexo, la talla, el peso y el grupo étnico. A estos factores se han sumado en los últimos años, gracias a numerosos autores, los musculoesqueléticos, como la morfología de la caja torácica y el desarrollo muscular. Conclusiones. Los diferentes estudios asocian la edad, el sexo, la raza, el peso y la altura, y los factores musculoesqueléticos torácicos a la función pulmonar. Sin embargo, son necesarios más estudios que expliquen esta influencia (AU)
Introduction: Within their assessment tools, the physical therapist uses those designated for the measurement of lung function. Having extensive knowledge about the physical factors affecting normal lung function is important for the physical therapist. This paper aims to clarify those physical factors that condition pulmonary function. Aims: To review the bibliography available that relate the physical factors having an influence on pulmonary function. Search strategy: The search was made with the following databases: CINAHL, Ovid, Scopus, ScienceDirect and PubMed, with time antiquity limited to the last 25 years. Synthesis of results: A total of 90 articles were obtained from the search. The authors have stated that physical factors of pulmonary function include age, sex, height, weight and ethnic group. In recent year, many authors have also added musculoskeletal factors, morphology of the thoracic cavity and muscle development. Conclusions: The different studies associate age, sex, race, height and weight and thoracic musculoskeletal factors to pulmonary function. However, more studies are needed to explain this influence (AU)
