Single 30-minute preoperative respiratory physiotherapy,
does it really help with Reduced 14-day postoperative pulmonary complications and pneumonia?
research showsThe grade is B. In a publicly and noncommercially funded multicenter randomized trial, one 30-minute session reduced pulmonary complications to 27/218 (12.4%) versus 58/214 (27.1%) and pneumonia to 18/218 (8.3%) versus 42/214 (19.6%). The clinical-event effect was large, but no second independent confirmatory trial of this exact protocol was established, giving B with 76 points.
ads claimThe result does not mean 30 minutes prevents every complication. It was tested before elective open upper abdominal surgery, delivered by experienced physiotherapists, with standardized postoperative early ambulation.
Useful facts when choosing a product
- The intervention was one face-to-face 30-minute session covering complications, early ambulation, demonstration, and practice of deep breathing.
- Both groups received the same booklet and routine postoperative care; no additional prophylactic chest physiotherapy or incentive spirometry was provided in the trial.
- Verdict 1899 addresses postoperative incentive spirometry, a different timing and intervention.
What the research actually shows
Boden randomized 441 adults awaiting elective major open upper abdominal surgery to booklet control (219) or 30-minute physiotherapy (222). The primary analysis included 214 and 218, totaling 432. Pulmonary complications were 27/218 versus 58/214, absolute risk reduction 15 points (95% CI 7-22), adjusted HR 0.48 (0.30-0.75), NNT 7 (5-14). Pneumonia was 18/218 versus 42/214, adjusted HR 0.45 (0.26-0.78). Twelve-month mortality HR was null at 0.78 (0.41-1.48).
Why this is classified as B (76)
A large publicly funded multicenter randomized trial showed large reductions in the prespecified primary pulmonary-complication event and pneumonia. Lack of a second independent confirmatory trial and a registry-update omission give B with 76 points.
Counterpoint. A 2024 individual-participant meta-analysis supports the direction but pools different protocols and was not counted as independent replication of this exact 30-minute session.
Rejudgment record. Cross-check applied — We cross-checked concealed allocation, analyzed population, primary endpoint, pulmonary-complication and pneumonia effects, funding, and registry correction against the paper, protocol, and ANZCTR.
| Endpoint | H | Hard endpoint - actual events such as death |
| Replication | R1 | Single confirmatory trial |
| Independence | I2 | Decisive evidence is publicly or non-profit funded |
| Effect size | E+ | Meets the clinically important threshold |
The scoring table and the verdict agree (B).
Sub-claim grades by effect
This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.
| Effect (sub-claim) | Grade | Basis |
|---|---|---|
| One 30-minute preoperative respiratory physiotherapy session reduces 14-day pulmonary complications after upper abdominal surgery. | B | The prespecified primary endpoint succeeded in a large publicly funded trial. |
| The session reduces 12-month mortality. | D | Mortality HR 0.78 (0.41-1.48) was null. |
Cross-check — Codex and Claude
Evidence Table
| Study | Design | Sample | Funding | Endpoint | Result | Weight |
|---|---|---|---|---|---|---|
| Study 1 | Patient- and assessor-blinded multicenter pragmatic randomized placebo-controlled superiority trial | 214 | Competitive grants from Clifford Craig Foundation, University of Tasmania, Waitemata DHB/Awhina, Three Harbours Health Foundation, and hospital departments; no funder role | Pulmonary complication within 14 postoperative days assessed daily by Melbourne Group Score | PPC 27/218 (12.4%) versus 58/214 (27.1%), adjusted HR 0.48 (95% CI 0.30-0.75); pneumonia 18/218 versus 42/214, HR 0.45 (0.26-0.78) | Only large direct confirmatory trial |
Receipt — 2 References
All 2 cited sources were verified for existence at the original page (as of 2026-08-14).
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-14 · Corrections: none
Cite this verdict
[Chamgap] Single 30-minute preoperative respiratory physiotherapy x prevention of pulmonary complications — Evidence Grade B·76. 2 cited sources checked. Source: https://chamgap.com/en/verdicts/energy/single-preoperative-physiotherapy-session-upper-abdominal-surgery-pulmonary-complications/ · CC BY 4.0CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.
What this document does and does not do
Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.