Postoperative respiratory physiotherapy in thoracic and upper abdominal surgery: An integrative review
DOI:
https://doi.org/10.62827/fb.v27i7.1243Keywords:
Physical Therapy Modalities; Breathing Exercises; Postoperative Care; Postoperative Complications; Functional Status.Abstract
Introduction: Thoracic and upper abdominal surgery impair ventilatory mechanics and mobility, increasing the risk of pulmonary complications and functional loss. Objective: To synthesize the available evidence on the effects and delivery characteristics of respiratory physiotherapy with a postoperative component on pulmonary, functional, and hospital recovery outcomes. Methods: An integrative review was conducted with searches until July 22, 2026, in PubMed, Scientific Electronic Library Online, and Physiotherapy Evidence Database. Comparative studies published from January 2020 to the search date in Portuguese, English, or Spanish were eligible. Selection and extraction followed a single-reviewer workflow without independent duplication, and Mixed Methods Appraisal Tool judgments were reported by domain. Results: A total of 374 records were identified; 37 duplicates were removed, 48 full texts were sought, 14 were not retrieved, and 34 were assessed; 23 studies were included. Interventions comprised respiratory muscle training, lung expansion and positive-pressure techniques, airway clearance, associated early mobilization, and multimodal programs. Some studies reported fewer pulmonary complications, whereas pulmonary function, functional capacity, and length of stay showed variable responses. In randomized trials, outcome-assessor blinding was the most frequently uncertain domain; in nonrandomized studies, uncertainty mainly concerned representativeness and control of confounding. Conclusion: The findings suggest possible benefit from early, integrated strategies, but cointerventions and study designs preclude attributing this pattern exclusively to respiratory physiotherapy. Protocol heterogeneity and confounding prevent identification of a superior modality.
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Copyright (c) 2026 Rafael Viana dos Santos Coutinho, Caroline Zanella, Gabriel Rigo Bianchi, Thiago Moreira Goivinho, Luiza Moura Trevizan (Autor)
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