Thoracic surgery is the primary intervention used in the treatment of diseases affecting the lungs, pleura, chest wall, and mediastinum. Postoperative changes occur in both lung functions and clinical symptoms due to the procedure itself and patient-related factors. After thoracic surgery, patients often experience reduced exercise tolerance and impaired respiratory functions, negatively affecting their participation in daily activities, functional levels, and quality of life. In open thoracotomies, the incision site, severed muscles, and the size of the incision can impact upper extremity and trunk functions. The aim of this study is to investigate the effects of physiotherapy applied through digital methods on respiratory functions, respiratory muscle strength, functional capacity, upper extremity muscle strength, and quality of life in patients who have undergone thoracic surgery.
Patients who underwent open thoracotomy
Agreement to participate in the study
Being between the ages of 18-75
Having an internet connection at home and being able to participate in video-conference sessions via desktop-laptop computers, smartphones, electronic tablets, etc.
Pneumonectomy surgeries
Having a cardiac, orthopedic, neurological or systemic disease that would prevent exercise
Having mental, communication or behavioral disorders that would cause problems in understanding commands and questions or performing exercises.
Participating in a pulmonary rehabilitation program before surgery
Parallel
Exercise
Other interventionExercise sessions will begin with flexibility exercises targeting the shoulder and neck regions. This will be followed by breathing exercises utilizing fundamental respiratory techniques. Extremity exercises will include movements focused on the upper extremities and trunk, with progression applied according to a pre-established plan. Each session will conclude with cool-down exercises. Additionally, patients will be encouraged to engage in regular walking on a weekly basis.
Standard care
Other interventionPatients will receive education regarding the critical aspects to consider after hospital discharge. Standard postoperative care protocols will be implemented.
Forced vital capacity (FVC)
The volume of air exhaled during a full and strongest exhalation possible after a full inspiration, as measured by a spirometry device.
Forced expiratory volume in 1 second (FEV1)
FEV1 is the expiratory volume in the first second of the FVC maneuver.
Tiffeneau ratio (FEV1/FVC)
The FEV1/FVC represents the fraction of air a patient exhales in the first second. This measurement is crucial for detecting airflow obstruction.
Peak expiratory flow (PEF)
Peak Expiratory Flow (PEF) is defined as a maximal expiratory flow generated during a simple maneuver using a peak flow meter via a mouthpiece.
Shoulder Joint Range of Motion Measurement
Change of shoulder flexion and abduction range of motion
Trunk Lateral Flexion Flexibility
It is the measurement of the distance between the first and last points during lateral flexion of the trunk with a tape measure. (in centimeters)
Chest Expansion
Evaluation of change in chest expansion. The largest differences between maximum inspiration and maximum expiration is recorded as chest expansion.
Shoulder Pain
Assessment is made using the Shoulder Pain and Disability Index. Higher scores indicate more severe pain and greater disability.
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