Università degli studi di Modena e Reggio Emilia

Background and aim. Several diseases may affect the thoraco-pulmonary system. In most cases resection surgery represents the elective therapy. To date, consensus is still lacking on the efficacy of post-surgery rehabilitation (PR) in these patients. Aim of our study was, therefore, to evaluate the effectiveness of a PR in patients undergoing thoraco-polmonary resection surgery. Patients and measurements. Forty patients referred for PR "Villa Pineta" Hospital-Rehabilitation Centre (in the period January 2006 to December 2007) after thoraco-pulmonary resection surgery were studied; 24 out of them had been directly transferred from the Surgery Unit (Early Rehabilitation), while other 16 came from their home with surgery having taken place at least 15 days before (Late Rehabilitation). The following outcome measures were recorded at baseline and at the end of PR: respiratory muscle performance (MIP and MEP), arterial blood gases (ABG - PaO2, PaCO2, pH, SatO2, PaO2/FiO2), the distance walked at the 6 minute test (6MWD) with related symptoms (dispnoea and muscle fatigue), scale of chronic dispnoea (MRC), questionnaire of perceived quality of life (SGRQ). Results. After PR, significant improvements (p <0.05) related to MIP-MEP, 6MWD with symptoms, MRC and SGRQ have been recorded in both subgroups. Only patients in the Early Rehabilitation group also showed improvements of blood oxygenation (PaO2, SatO2, PaO2/FiO2). Univariate analysis performed among groups in all the outcomes taking number and percentage of patients improved (as assessed by a pre-defined cut-off), has shown that both dyspnea (p =0.014) and muscle fatigue (p = 0.046) significantly differ in favour of the Early rehabilitation group. Conclusions. Our study suggests that rehabilitation may produce clinically relevant improvements in patients recovering from thoraco-pulmonary resection surgery. Effectiveness is more likely to be higher if program is applied early after surgery.