PURPOSE: This clinical practice guideline (CPG) evaluates the evidence for cardiorespiratory physical therapy (CPT) techniques in the management of patients after thoracic, cardiac and abdominal surgery. We evaluated the evidence for breathing exercises, incentive spirometry (IS), manual and other techniques used for this population. METHODS: Relevant articles were identified from CINAHL, and Medline databases, using keywords. Articles were assessed by two researchers to determine eligibility, and given a Jadad quality score. Only randomized (controlled and cross-over) trials were included. Appropriate data was extracted, labeled using Sackett's levels of evidence, and grouped by intervention and population. RESULTS: Eleven recommendations were made addressing the following aspects of peri-operative CPT TENS (transcutaneous electrical nerve stimulation), IS, PEP (positive expiratory pressure), intermittent positive pressure breathing, breathing exercises, inspiratory muscle training, and positioning. Clinical judgement was recommended in three other areas. CONCLUSIONS: This CPG provides a rigorous analysis of the literature and translates evidence into practice.

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A brief summary and a critical assessment of this review may be available at DARE