Rehabilitation in the Postoperative Period Following Lung Resections: An Integrative Review

Abstract

Introduction: Pulmonary resection is a surgical intervention used in the treatment of different pulmonary diseases and may be associated with respiratory changes, reduced functional capacity, muscle weakness, and decreased physical activity during the postoperative period. In this context, rehabilitation plays an important role in patient recovery and includes strategies such as respiratory physiotherapy, respiratory muscle training, physical exercise, early mobilization, and outpatient or home-based follow-up programs. Objective: To analyze rehabilitation strategies used during the postoperative period following pulmonary resections and their relationship with respiratory, functional, and clinical recovery in patients. Methods: This is a descriptive and analytical literature review conducted through an integrative literature review, based on the methodological framework proposed by Whittemore and Knafl. Searches were conducted in the Virtual Health Library (BVS), Latin American and Caribbean Health Sciences Literature (LILACS), National Library of Medicine (PubMed/MEDLINE), Scopus, and Scientific Electronic Library Online (SciELO) databases. Eligibility criteria were established to include adult patients undergoing pulmonary resections, with an assessment of postoperative rehabilitation strategies. Study selection was performed independently by two reviewers, and the critical analysis was based on a systematic comparison of study designs, samples, protocols, and consistency of outcomes, without the use of formal quality assessment scores. Reviews and secondary studies were excluded. Results: Twelve primary studies were included, encompassing different rehabilitation strategies, including inspiratory and expiratory muscle training, respiratory physiotherapy, aerobic exercise, physical training, early mobilization, and outpatient or home-based rehabilitation programs. Favorable results were observed mainly in terms of respiratory muscle strength, exercise capacity, physical activity, pulmonary function, fatigue, quality of life, and functional recovery. However, some studies did not identify significant differences between the interventions and conventional care for certain outcomes, demonstrating substantial heterogeneity regarding protocols, timing of initiation, duration, and participant characteristics, which precludes the establishment of a uniform strategy. Conclusion: Rehabilitation during the postoperative period following lung resections is related to the recovery of various respiratory and functional aspects, ranging from inpatient interventions to outpatient or home-based follow-up. However, the magnitude and nature of the benefits vary depending on the strategy employed, the timing of the assessment, and the outcome analyzed, reflecting the heterogeneity of the synthesized studies and the absence of a formal assessment of risk of bias.