PURPOSE: Enhanced recovery after surgery (ERAS) has improved outcomes following elective surgery. This narrative review aimed to assess current evidence for post-operative physiotherapy interventions in general surgical procedures which adopt ERAS principles. MATERIALS AND METHODS: A systematic review of the literature between 2000 and 2017 was conducted. Randomised controlled trials (RCTs) that compared physiotherapy interventions for patients after the following elective ERAS procedures were included: gynaecologic, gastrectomy, gastrointestinal, pancreatic, bariatric, head and neck, breast, cystectomy, colorectal, colonic and liver. RESULTS: One study (two publications) was found to compare post-operative physiotherapy interventions in radical cystectomy patients on an ERAS pathway. The addition of a progressive exercise-based intervention improved aspects of health-related quality of life (dyspnoea (p < 0.05), constipation (p < 0.02) and abdominal flatulence (p <= 0.05)). Enhanced mobilisation was achieved, but no differences were observed in length of stay or severity of complications. CONCLUSIONS: It is essential that the paucity of research to assess post-operative physiotherapy interventions within ERAS cohorts is highlighted. The results of our literature search highlight that there is a role for post-operative physiotherapy in ERAS pathways. However, without well-conducted RCTs to evaluate procedure-specific interventions, the optimal type, timing, and dose will not be found and the potential for improving patient functional recovery will be limited.

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