Discharge and home program

Patients can be discharged from physiotherapy treatment at varying points according to their
recovery. A low-risk patient without postoperative complications may need only 3–4 days of
physiotherapy. However, high-risk patients and those suffer-ing from pulmonary complications
may need more days of physiotherapy. Once discharged, patients should be provided with a
detailed home program to stick with. They are advised to continue regular breathing exercises, to
gradually increase their mobility and daily activities, and to practice an airway clearance
technique whenever necessary. A graduated walking program can be initiated following hospital
discharge, as follows. Immediately after discharge, the postoperative patient should start walking
at a moderate level of effort for about 3 times a day for 5 minutes each time for a total of 15
minutes/day. Then, the patient should gradually increase the total walking time each week by 5
minutes, so that he or she becomes able to walk for a total of 30 minutes either intermittently or
continuously by the first month postoperatively. The patient can be educated to self monitor
effort intensity during walking. This can be achieved by observing his or her ability to talk
during walking without feeling short of breath. That is, if the patient is able to keep talking while
walking without interruption in speech or feeling difficulty in breathing, this means that he or she
is walking at a moderate intensity. However, if during walking, the patient feels unable to keep
talking continuously (i.e., his or her speech is interrupted), and/or feels shortness of breath while
talking, this means that his or her walking intensity has risen above the moderate level. At that
point, the patient can slow down and pace walking with breathing to return to the targeted
moderate in-tensity level of exercise.