• S Chumillas, J L Ponce, F Delgado, V Viciano, and M Mateu.
• Department of Rehabilitation, Lluis Alcanyís Hospital, Xàtiva, Valencia, Spain.
• Arch Phys Med Rehabil. 1998 Jan 1; 79 (1): 5-9.

ObjectiveTo investigate the efficacy of respiratory rehabilitation in preventing postoperative pulmonary complications (PPC) and to define which patients can benefit.DesignA randomized clinical trial.SettingA public hospital.PatientsEighty-one patients who had upper abdominal surgery were distributed into two homogeneous groups: control (n = 41) and rehabilitation (n = 40).InterventionBreathing exercises in the rehabilitation group.Main Outcome MeasuresPreoperative and postoperative clinical evaluation, spirometry, arterial gasometry, and simple chest X-rays.ResultsThe incidence of PPC was 7.5% in the rehabilitation group and 19.5% in the control group; the control group also had more radiologic alterations (p = .01). Stratified PPC analysis did not reveal significant differences between groups. However, high- and moderate-risk patients in the rehabilitation group had fewer PPC. Multivariate analysis showed a greater PPC risk associated with pulmonary history (p = .02) and duration of surgery longer than 120 min (p = .03), while rehabilitation exerted a protective effect (p = .06). Significant postoperative decreases in pulmonary volumes and arterial gas values were recorded in both groups, without significant differences.ConclusionsRespiratory rehabilitation protects against PPC and is more effective in moderate- and high-risk patients, but does not affect surgery-induced functional alterations.

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