Physiotherapy in patients with intestinal obstruction: respiratory function, early mobilisation and prevention of functional decline: A narrative review

Abstract

Introduction: Intestinal obstruction is a frequent cause of emergency surgical admission and subjects patients to prolonged bed rest, fasting, nasogastric decompression, pain and abdominal distension, conditions that favour deterioration of respiratory function and loss of functional capacity. Objective: To describe the role of physiotherapy in preserving respiratory function, promoting early mobilisation and preventing functional decline in patients with intestinal obstruction. Methods: This was a descriptive and qualitative narrative literature review. The literature search was conducted up to July 2026 in Medical Literature Analysis and Retrieval System Online (MEDLINE), accessed through PubMed, Embase, the Cochrane Library, Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Sciences Literature (LILACS) and Physiotherapy Evidence Database (PEDro), using controlled descriptors and free-text terms in Portuguese and English combined with Boolean operators. Selection involved screening titles and abstracts, followed by full-text assessment of potentially relevant publications. Inclusion decisions were reached by consensus among the authors, and the findings were analysed descriptively and thematically. Results: No physiotherapy intervention studies were identified in which patients with intestinal obstruction were the target population; the recommendations therefore derive from indirect evidence and pathophysiological inference. Abdominal distension reduces lung volumes and predisposes to atelectasis, whereas immobility accelerates muscle loss. Structured physiotherapy interventions combining respiratory strategies and progressive mobilisation show more consistent results in abdominal surgery and intensive care, whereas isolated respiratory techniques have less certain benefit. Conclusion: There is clinical plausibility for physiotherapy integrated into multidisciplinary care, but transferring benefits observed in related populations requires individualisation. Physiotherapy addresses the respiratory and functional consequences of obstruction rather than the mechanical obstruction itself.