Evaluation of positive expiratory pressure (PEP) devices as an adjunct to cardio-respiratory physiotherapy in patients following open abdominal surgery

 

Show simple item record

dc.contributor.advisor Manie, Shamila en_ZA
dc.contributor.advisor Pienaar, Lunelle en_ZA
dc.contributor.author Jacobs, Rene Catherine en_ZA
dc.date.accessioned 2016-02-02T13:47:20Z
dc.date.available 2016-02-02T13:47:20Z
dc.date.issued 2015 en_ZA
dc.identifier.citation Jacobs, R. 2015. Evaluation of positive expiratory pressure (PEP) devices as an adjunct to cardio-respiratory physiotherapy in patients following open abdominal surgery. University of Cape Town. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/16681
dc.description Includes bibliographical references en_ZA
dc.description.abstract Purpose: Cardio-respiratory physiotherapy for patients undergoing abdominal surgery has been found to be beneficial in improving lung function post-operatively and in the prevention and treatment of post-operative pulmonary complications (PPCs). The Blow Bottle, a Positive Expiratory Pressure (PEP) therapy device, is commonly used as an adjunct to physiotherapy. The Blow Bottle is low cost and can be easily made by the physiotherapist using readily available materials in the hospital setting. However, evidence to support the use of Blow Bottles in the post-operative management of abdominal surgery is minimal, with few studies reporting significant positive effects especially when compared to conventional cardio-respiratory physiotherapy techniques. Methodology: A randomized control was implemented in a public tertiary institution within the Western Cape. Patients admitted for open abdominal surgery via midline incision were eligible for the trial. Participants were randomly allocated to either the control group (CG) receiving conventional post-operative cardio-respiratory physiotherapy, or the intervention group (IG) who received the additional use of the Blow Bottle. Lung function and the development of post-operative pulmonary complications were the primary outcome s of this study. Lung Function was evaluated by means of spirometry testing and interpretation of Forced Expiratory Volume in 1 second (FEV 1) and Forced Vital Capacity (FVC). The development of post-operative pulmonary complications were diagnosed using the criteria by Mackay et al. (2005) where changes from pre-operative findings of auscultation; temperature, X-ray and sputum are evaluated post-operatively and recorded using the Adapted Abdominal Physiotherapy Outcomes Data Sheet (A-APODS). Results: A total of 19 participants were enrolled in the study, n=11 (CG) and n=8 (IG), predominantly female (n=14) and admitted for cancer related abdominal surgery (n=9). There was a statistically significant (p<0.05) marked reduction in post-operative lung function from baseline across groups, 62% in FEV 1 and 47% in FVC on the first post-operative day. The FEV 1 and FVC were similar across both the control and intervention groups for the first three post-operative days. On auscultation majority of participants had decreased breath sounds on the first post-operative day. However, no one participant developed a PPC across the duration of the study as diagnosed using the criteria by Mackay et al. (2005). Conclusion: Whether the additional use of the Blow Bottle is more beneficial than conventional post-operative cardio-physiotherapy alone is inconclusive due to the incremental drop out of participants from the study and small sample size. In this study there was however a significant reduction in lung function post-operatively. This mandates the need for further research investigating the abdominal surgical field and the use of devices to improve lung function, such as the Blow Bottle, as literature is scant and outdated, and sorely lacking in the resource constraint South African hospital settings. en_ZA
dc.language.iso eng en_ZA
dc.subject.other Physiotherapy en_ZA
dc.title Evaluation of positive expiratory pressure (PEP) devices as an adjunct to cardio-respiratory physiotherapy in patients following open abdominal surgery en_ZA
dc.type Master Thesis
uct.type.publication Research en_ZA
uct.type.resource Thesis en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Division of Physiotherapy en_ZA
dc.type.qualificationlevel Masters
dc.type.qualificationname MSc (Physiotherapy) en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Jacobs, R. C. (2015). <i>Evaluation of positive expiratory pressure (PEP) devices as an adjunct to cardio-respiratory physiotherapy in patients following open abdominal surgery</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Division of Physiotherapy. Retrieved from http://hdl.handle.net/11427/16681 en_ZA
dc.identifier.chicagocitation Jacobs, Rene Catherine. <i>"Evaluation of positive expiratory pressure (PEP) devices as an adjunct to cardio-respiratory physiotherapy in patients following open abdominal surgery."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Division of Physiotherapy, 2015. http://hdl.handle.net/11427/16681 en_ZA
dc.identifier.vancouvercitation Jacobs RC. Evaluation of positive expiratory pressure (PEP) devices as an adjunct to cardio-respiratory physiotherapy in patients following open abdominal surgery. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Division of Physiotherapy, 2015 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/16681 en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Jacobs, Rene Catherine AB - Purpose: Cardio-respiratory physiotherapy for patients undergoing abdominal surgery has been found to be beneficial in improving lung function post-operatively and in the prevention and treatment of post-operative pulmonary complications (PPCs). The Blow Bottle, a Positive Expiratory Pressure (PEP) therapy device, is commonly used as an adjunct to physiotherapy. The Blow Bottle is low cost and can be easily made by the physiotherapist using readily available materials in the hospital setting. However, evidence to support the use of Blow Bottles in the post-operative management of abdominal surgery is minimal, with few studies reporting significant positive effects especially when compared to conventional cardio-respiratory physiotherapy techniques. Methodology: A randomized control was implemented in a public tertiary institution within the Western Cape. Patients admitted for open abdominal surgery via midline incision were eligible for the trial. Participants were randomly allocated to either the control group (CG) receiving conventional post-operative cardio-respiratory physiotherapy, or the intervention group (IG) who received the additional use of the Blow Bottle. Lung function and the development of post-operative pulmonary complications were the primary outcome s of this study. Lung Function was evaluated by means of spirometry testing and interpretation of Forced Expiratory Volume in 1 second (FEV 1) and Forced Vital Capacity (FVC). The development of post-operative pulmonary complications were diagnosed using the criteria by Mackay et al. (2005) where changes from pre-operative findings of auscultation; temperature, X-ray and sputum are evaluated post-operatively and recorded using the Adapted Abdominal Physiotherapy Outcomes Data Sheet (A-APODS). Results: A total of 19 participants were enrolled in the study, n=11 (CG) and n=8 (IG), predominantly female (n=14) and admitted for cancer related abdominal surgery (n=9). There was a statistically significant (p<0.05) marked reduction in post-operative lung function from baseline across groups, 62% in FEV 1 and 47% in FVC on the first post-operative day. The FEV 1 and FVC were similar across both the control and intervention groups for the first three post-operative days. On auscultation majority of participants had decreased breath sounds on the first post-operative day. However, no one participant developed a PPC across the duration of the study as diagnosed using the criteria by Mackay et al. (2005). Conclusion: Whether the additional use of the Blow Bottle is more beneficial than conventional post-operative cardio-physiotherapy alone is inconclusive due to the incremental drop out of participants from the study and small sample size. In this study there was however a significant reduction in lung function post-operatively. This mandates the need for further research investigating the abdominal surgical field and the use of devices to improve lung function, such as the Blow Bottle, as literature is scant and outdated, and sorely lacking in the resource constraint South African hospital settings. DA - 2015 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Evaluation of positive expiratory pressure (PEP) devices as an adjunct to cardio-respiratory physiotherapy in patients following open abdominal surgery TI - Evaluation of positive expiratory pressure (PEP) devices as an adjunct to cardio-respiratory physiotherapy in patients following open abdominal surgery UR - http://hdl.handle.net/11427/16681 ER - en_ZA


Files in this item

This item appears in the following Collection(s)

Show simple item record