The role of routine physiotherapy following open heart valve surgery in South Africans

Charmoy, Suzanne de
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Post-operative physiotherapy for patients who have undergone uncomplicated coronary artery surgery has been shown to be of little value in preventing or restoring the abnormalities that occur in lung function, hypoxaemia, chest radiograph changes and length of post-operative hospital stay. This study aimed to establish whether similar results would be found for a group of patients undergoing cardiac valve surgery who had an uncomplicated post-operative course. The relevance of using valve surgery patients is that a very large number of state health care patients undergo valve surgery due to the remaining high incidence of rheumatic heart disease in South Africa. Thirty consecutive patients booked for elective valve surgery between June and September 1995 were included in the study once written informed consent had been obtained. The patients were then divided into two groups, a treatment group and a nontreatment group. The treatment group received a regimen o f breathing exercises, coughing and mobilisation for the first four post-operative days while the non-treatment group were given a set of instructions to mobilise out of bed. The two groups were well matched for age, height, weight, body mass index and intraoperative details. Post-operative/y arterial blood gas values, chest x-rays, tem perature and length of stay were assessed to determine if there was any benefit to a regime of physiotherapy. The data was analysed using non-paramctrical statistical tests and the chi-square test. The results of this study show that there is no benefit to a regime of physiotherapy in a group of patients who have undergone uncomplicated, elective valve surgery.