Comparison of physiotherapy practice in university hospitals following chest trauma between two countries with different trauma panoramas: a prospective observational study

Abstract

Objectives The study aimed to describe and compare the clinical physiotherapy management of patients hospitalised due to chest trauma in South Africa (SA) and Sweden.Design A prospective observational multicentre international study.Setting Two university-affiliated public sector hospitals in SA and four university-affiliated public sector hospitals in Sweden.Participants In total, 364 adults, hospitalised due to chest trauma were consecutively recruited of which 179 were from SA and 185 were from Sweden.Outcome measures Physiotherapy practice was recorded in parallel with standard care. In addition, pulmonary complications and length of hospital stay were collected.Results Despite differences in the type of trauma between the national cohorts (83% penetrating traumas in SA and 95% blunt traumas in Sweden), most patients received physiotherapy treatment during the first 3 days in hospital. Physiotherapy interventions such as mobilisation (day 1: sit on edge of bed; days 1–3: walking) and exercises to maintain range of motion (days 1–3: shoulder; day 3: trunk) were initiated earlier in SA (p<0.05). Treatment with the active cycle of breathing technique was more used in SA while deep breathing exercises were more common in Sweden and positive expiratory pressure was common in both countries. Length of stay was in mean 5.4 (95% CI 4.8, 6.0) days in SA and 6.6 (5.8, 7.4) days in Sweden (p=0.024).Conclusions Despite differences in trauma panoramas and the national cohorts there seem to be similarities in clinical physiotherapy practices between the two countries.