The Role of Physiotherapy in Post-Surgical Recovery: From Passive Healing to Functional Empowerment

Abstract

Background: Modern postoperative management increasingly emphasizes active rehabilitation over passive convalescence. While physiotherapy is widely implemented, the magnitude and consistency of its benefits across surgical specialties remain inadequately quantified.

Objective: To assess the effects of exercise-based programs, manual therapy, and electrotherapy on pain relief, functional recovery, range of motion, ambulation, complication rates, and hospital length of stay in adult patients following major surgery.

Methods: A meta-analysis of 15 randomized controlled trials (N = 1,280) was conducted, covering orthopedic (arthroplasty, fracture fixation), cardiothoracic (CABG, lung resection), spinal (lumbar decompression), and abdominal procedures. Outcomes were pooled as mean differences (MD), standardized mean differences (SMD), or relative risks (RR) using random-effects models with 95% confidence intervals.

Results: Physiotherapy significantly improved key outcomes compared to usual care. Pain scores decreased (SMD –0.72, 95% CI –0.90 to –0.54), quadriceps strength increased after TKA (SMD +0.81, 95% CI 0.51–1.11), and 6-minute walk distances improved (MD +45.3 m, 95% CI 33.1–57.5). ROM increased (MD +12.1°, 95% CI 7.3–16.9), and hospital stay

was shortened (MD –1.8 days, 95% CI –2.9 to –0.7). Complication risk showed a non-significant trend toward reduction (RR 0.78, 95% CI 0.60–1.02).

Conclusions: Postoperative physiotherapy leads to measurable improvements in pain, mobility, and function, supporting its role as a core component of recovery. Tailored rehabilitation should be integrated into surgical pathways, with further research to optimize strategies and target high-risk populations.