Telerehabilitation for thoracic surgery patients: An effective alternative during the pandemic

Abstract

Background: This study aims to evaluate the effectiveness of application of physiotherapy via remote telerehabilitation in the early postoperative period following thoracic surgery. Methods: Between October 2020 and July 2024, a total of 40 patients (25 males, 15 females; mean age: 57.8 +/- 9.6 years; range, 42 to 77 years) who underwent thoracic surgery due to Stage 1A-3B non-small cell lung cancer were included in this randomized-controlled clinical study. The patients were divided into two groups: the telerehabilitation group (TG, n=20) and the control group (CG, n=20). Patients in the TG participated in a teleconference-based exercise program supervised by a physiotherapist, starting the day before surgery and continuing daily until discharge. Patients in the CG received a single preoperative exercise session and an educational brochure. All patients were assessed at five time points: preoperatively, immediately after surgery, prior to discharge, at one to three months post-discharge, and at six months post-discharge. Outcome measures included the duration of intensive care unit stay, total hospital stay, chest drain duration, postoperative complications, inflammatory biomarkers, pain, dyspnea, fatigue, spirometry, and State-Trait Anxiety Inventory (STAI) scores. Results: Both groups had similar baseline characteristics including comorbidities and types of surgery (p>0.05). There were no significant differences in the intensive care unit stay duration (p=0.739), total hospital stay (p=0.311), or chest drain duration (p=0.431) between the groups. However, TG showed significantly lower pain and fatigue levels compared to CG (p<0.05). Conclusion: Telerehabilitation effectively reduced pain and fatigue in patients after thoracic surgery. The lack of significant differences in other outcomes may be attributed to variations in patient compliance. These findings suggest that telerehabilitation can be a valuable alternative to traditional rehabilitation, particularly during pandemic or isolation.