Physical Therapy for the Management of Postoperative Pain After Minimally Invasive Thoracic Surgery
To evaluate the effectiveness of a protocolized physical therapy program in reducing postoperative chest and abdominal wall pain after minimally invasive thoracic surgery. To characterize neuropathic and nociceptive components of post-thoracotomy pain using the Perioperative Neuropathic Pain Assessment Form
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Luismiguel Cotamo, Research Assistant
- Phone Number: 305-689-3366
- Email: lxc332@miami.edu
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Are ≥18 years old
- Undergo minimally invasive lung surgery including Video assisted thoracic surgery (VAST) and Robotic assisted thoracic surgery (RATS)
- Wedge resection
- Segmentectomy
- Lobectomy
- Pneumonectomy
- Present to the 2-week postoperative clinic visit
- Report pain score ≥4 on the Numeric Rating Scale
- Can participate in physical therapy at the University of Miami (UM) downtown facility
Exclusion Criteria:
- Undergo esophagectomy
- Undergo mediastinal or thymic resection procedures
- Are unable to participate in physical therapy due to severe medical comorbidities or geographical limitations
- Have cognitive impairment preventing participation in assessments
- Decline participation
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Physical Therapy + Standard of Care Analgesia Therapy Group
Participants will receive standard postoperative analgesic therapy per routine clinical care throughout the study period. In addition, participants will complete protocolized physical therapy consisting of 1 session per week for 4 weeks, beginning at postoperative week 4. Total participation in this arm is approximately 6 months |
Protocolized physical therapy administered once weekly for 4 weeks beginning at postoperative week 4. Therapy includes chest wall strengthening, shoulder girdle mobilization, postural training, abdominal strengthening, inspiratory muscle training, and pain management modalities (cryotherapy, moist heat, ultrasound). Postoperative analgesic therapy administered as part of routine clinical standard of care and determined by the treating physician. Medications may include acetaminophen (Tylenol), celecoxib (Celebrex), ibuprofen (Advil), ketorolac (Toradol), gabapentin (Neurontin), and oxycodone (OxyContin). Dosing, frequency, and duration will be individualized based on patient need and determined by the treating clinician. |
|
Active Comparator: Standard Care Analgesia Therapy Group
Participants will receive standard postoperative analgesic therapy per routine clinical care throughout the study period. Total participation in this arm is approximately 6 months. |
Postoperative analgesic therapy administered as part of routine clinical standard of care and determined by the treating physician. Medications may include acetaminophen (Tylenol), celecoxib (Celebrex), ibuprofen (Advil), ketorolac (Toradol), gabapentin (Neurontin), and oxycodone (OxyContin). Dosing, frequency, and duration will be individualized based on patient need and determined by the treating clinician. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Postoperative Pain Intensity
Time Frame: Baseline (2 weeks postoperatively), 8 weeks, and 6 months postoperatively
|
Pain intensity will be measured using the Numeric Rating Scale (NRS), a patient-reported scale ranging from 0 (no pain) to 10 (worst possible pain). Time Frame: Baseline (2 weeks postoperatively), 8 weeks, and 6 months postoperatively |
Baseline (2 weeks postoperatively), 8 weeks, and 6 months postoperatively
|
|
Change in Neuropathic Pain Score
Time Frame: Baseline (2 weeks postoperatively), 8 weeks, and 6 months postoperatively
|
Neuropathic pain will be measured using the DN4 (Douleur Neuropathique en 4 Questions) questionnaire, with total scores ranging from 0 to 10. A score of ≥4 indicates the presence of neuropathic pain. |
Baseline (2 weeks postoperatively), 8 weeks, and 6 months postoperatively
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Cumulative Opioid Exposure
Time Frame: 8 weeks, and 6 months postoperatively
|
Cumulative opioid exposure, calculated as the total morphine milligram equivalents (MME) of opioid medications used during the assessment periods |
8 weeks, and 6 months postoperatively
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Diego Avella-Patino, MD, University of Miami
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 20260414
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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