KINE PREOP pilot study: Prehabilitation in fast-track thoracic surgery protocol

Introduction. - Prehabilitation preceding oncological thoracic surgery according to a fast-track enhanced recovery after surgery (ERAS) protocol is in full expansion. Many recent studies have demonstrated the benefits of preoperative pulmonary rehabilitation as a means of reducing postoperative pulmonary complications. Unfortunately, it is rarely carried out by independent physiotherapists, and questions arise: is it feasible in private practice? Can it yield results similar to those achieved in institutional settings?Design. - The study was non-interventional. The patients included had to be able to practice physical activities according to a standard ERAS approach. The endpoints were: postoperative pulmonary complications, physical condition (VO2max), and impact on the quality of life (SF-36 questionnaire). A statistical study was conducted to analyze the results with parametric and non-parametric tests.Results. - Between June 2018 and January 2019, nine patients were included. From two to fifteen pulmonary rehabilitation sessions were carried out by six volunteering independent phy-siotherapists. Only two minor postoperative complications ensued. VO2max post rehabilitation increased on average by 2.4 mL.kg-1.min-1. The SF-36 physical score increased significantly (+17.9%). The physical functioning (PF) (+28.9), physical restrictions (PR) (+11.1) and vitality (VT) (+16.7) sub-scores likewise improved.Conclusion. - Based on a literature review and on comparisons, our results seem promising. While further investigations are needed, it would seem that prehabilitation by independent physiotherapists leads to results similar to those achieved in inpatient prehabilitation.(c) 2022 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Automated summary

Prehabilitation prior to oncological thoracic surgery has shown to be valuable in reducing postoperative pulmonary complications. This study aimed to determine whether preoperative pulmonary rehabilitation carried out by independent physiotherapists is feasible in private practice and can achieve similar results to institutional settings. The results suggest that prehabilitation by independent physiotherapists can lead to outcomes comparable to inpatient prehabilitation.