The effects of a physiotherapy programme on patients with a pleural effusion: a randomized controlled trial

Objective: To investigate the effects of a physiotherapy protocol on patients with pleural effusion. Design: Randomized controlled trial. Setting: University hospital. Participants: A total of 104 consecutive inpatients with a medical diagnosis of pleural effusion. Intervention: Patients were randomly allocated to a control group receiving standard treatment (medical treatment and drainage) or an intervention group treated with physiotherapy added to standard treatment. The physiotherapy programme included deep breathing exercises, mobilizations and incentive spirometry. Main outcome measures: Spirometric predicted values and chest radiographs were measured before treatment and at discharge and the length of hospital stay was recorded. Assessors were blinded to the intervention. Results: A comparative analysis showed a significant improvement of spirometric parameters in the intervention group; pre-to-post hospitalization predicted values showed significant changes in vital capacity (73.1 12.6% to 72.13 +/- 13.7 %, P<0.001 ), forced expiratory volume in first second (72.13 +/- 13.7% to 78.98 +/- 16.9%, P<0.001) and forced expiratory flow at 25-75 % (64.8 +/- 35.1% to 76.78 +/- 35.3%, P=0.198) compared to the control group that showed no significant changes across treatment. The radiographic findings showed better scores on the affected side of the thorax at discharge in the physiotherapy group. Length of hospital stay was also significantly (P=0.014) shorter in the intervention group (26.7 +/- 8.8 days) compared to the control group (38.6 +/- 10.7 days). Conclusions: A physiotherapy programme added to standard treatment improves the spirometric parameters and the radiological findings and reduces the hospital stay in patients with a pleural effusion.