Article type
Abstract
Background: Road traffic accidents and interpersonal violence are forms of trauma that contribute to the global burden of diseases. Individuals who experience such trauma are likely to acquire chest wall injuries. Tube thoracostomy is often part of the surgical management of a patient who sustained penetrating trauma and presents with intra-pleural abnormalities. The injury can have effects on the respiratory and cardiovascular systems that lead to problems related to ventilation, performing activities of daily life and thus variable levels of disability. Rehabilitation services such as physiotherapy are part of the multidisciplinary team influencing patient outcomes.
Objectives: The objectives of this review were to establish the physiotherapy interventions implemented in patients with tube thoracostomy during acute care stay and evaluate the effects on the duration of tube drainage and hospital length of stay (LOS).
Methods: An effectiveness systematic review using the PICO approach and JBI SUMARI was carried out. A systematic search of literature published through PubMed, CINAHIL Plus, The Cochrane Library, Physiotherapy Evidence Database (PEDro), Scopus, Science Direct and Google Scholar from the conception of databases was done. Meta-analysis for early versus late physiotherapy when reviewing the impact on hospital LOS and duration of intra-pleural drainage was assessed. The reviewers of this project were healthcare practitioners involved in the care of trauma patients.
Results: Six studies were included in the final review (n = 596) of which most included males with an average age between 27 and 32 years. The most common mechanism of injury was stabbings followed by gunshot wounds. Proprioceptive neuromuscular facilitation (PNF) assisted with pain reduction and improved trunk mobility. Continuous positive airway pressure (CPAP) ventilation, respiratory physiotherapy, upper limb and trunk exercises as well as ambulation reduced the duration of intra-pleural drainage, hospital LOS and pulmonary complications. The meta-analysis of early versus late physiotherapy implementation revealed a significant effect in reducing both hospital LOS (p=0.00) and duration of intra-pleural drainage (p=0.00) which may influence hospital cost. The quality of evidence of studies included was however low.
Conclusions: Multimodality therapy implemented early after tube thoracostomy is important for patients with intra-pleural abnormalities promoting early, effective recovery.
Objectives: The objectives of this review were to establish the physiotherapy interventions implemented in patients with tube thoracostomy during acute care stay and evaluate the effects on the duration of tube drainage and hospital length of stay (LOS).
Methods: An effectiveness systematic review using the PICO approach and JBI SUMARI was carried out. A systematic search of literature published through PubMed, CINAHIL Plus, The Cochrane Library, Physiotherapy Evidence Database (PEDro), Scopus, Science Direct and Google Scholar from the conception of databases was done. Meta-analysis for early versus late physiotherapy when reviewing the impact on hospital LOS and duration of intra-pleural drainage was assessed. The reviewers of this project were healthcare practitioners involved in the care of trauma patients.
Results: Six studies were included in the final review (n = 596) of which most included males with an average age between 27 and 32 years. The most common mechanism of injury was stabbings followed by gunshot wounds. Proprioceptive neuromuscular facilitation (PNF) assisted with pain reduction and improved trunk mobility. Continuous positive airway pressure (CPAP) ventilation, respiratory physiotherapy, upper limb and trunk exercises as well as ambulation reduced the duration of intra-pleural drainage, hospital LOS and pulmonary complications. The meta-analysis of early versus late physiotherapy implementation revealed a significant effect in reducing both hospital LOS (p=0.00) and duration of intra-pleural drainage (p=0.00) which may influence hospital cost. The quality of evidence of studies included was however low.
Conclusions: Multimodality therapy implemented early after tube thoracostomy is important for patients with intra-pleural abnormalities promoting early, effective recovery.