A Randomized Controlled Trial of Multisensory Stimulation and Family-Involved Rehabilitation in Elderly Thoracic Surgery Patients

Summary

This randomized controlled trial found that combining multisensory stimulation with family-involved rehabilitation was associated with reduced pain and anxiety, as well as improved physical recovery in elderly patients following thoracic surgery.

Abstract

Elderly patients undergoing thoracic surgery often experience postoperative pain, anxiety, and delayed functional recovery. Multisensory stimulation nursing (MSSN) and family-participatory rehabilitation training (FPRT) are recognized non-pharmacological approaches; however, evidence for their combined use in this population remains limited. This study evaluated the effects of MSSN combined with FPRT on pain, anxiety, sleep quality, and physical function in elderly patients after thoracic surgery. In this randomized controlled trial, patients aged ≥65 years undergoing elective thoracic surgery were assigned to a control group (routine care, n = 38) or an intervention group (routine care plus MSSN and FPRT, n = 39). MSSN involved 20-min multisensory sessions five times per week for 4 weeks, while FPRT included structured family-assisted respiratory and mobility exercises. Outcomes included pain (NRS), anxiety (HADS-A), sleep quality (PSQI), grip strength, and 6-minute walking distance (6MWD), assessed at baseline, 2 weeks, and 4 weeks. The intervention group demonstrated significantly greater reductions in pain (group × time interaction, P = 0.01; week 2: B = 0.21, P = 0.007; week 4: B = 0.23, P = 0.004) and anxiety (B = -3.42, P = 0.002) compared to the control group. Significant improvements were also observed in sleep quality (PSQI change: -2.71 ± 1.13 vs. -0.94 ± 1.25, P = 0.004), grip strength (week 4: B = -0.31, P = 0.008), and 6MWD (54 m vs. 27 m improvement, P < 0.01), with the 54 m improvement exceeding the estimated minimal clinically important difference (30 m). Postoperative pulmonary complications were lower in the intervention group (7.5% vs. 22.5%), and no adverse events were reported. Combined MSSN and FPRT may safely reduce pain and anxiety while improving sleep and functional recovery in elderly thoracic surgery patients.

Introduction

The aging global population has led to a rapid increase in elderly patients undergoing major thoracic surgery¹. These individuals face heightened risks of postoperative complications, pain, anxiety, and functional decline due to age-related physiological changes and reduced resilience². Traditional postoperative care primarily focuses on analgesic control and early ambulation. However, this biomedical model often overlooks the psychological and sensory dimensions of recovery, which are critical for elderly patients³. Fortunately, recent research highlights the efficacy of non-pharmacological inter....

Protocol

This study was approved by the Ethics Committee of The Affiliated Hospital of Southwest Medical University. All participants and their designated family caregivers provided written informed consent prior to participation. The study was registered in the Chinese Clinical Trial Registry. All procedures adhered to the Declaration of Helsinki principles, and participants retained the right to withdraw at any stage without affecting their clinical care. The equipment and the software used are listed in the Table of Materials.

1. Study design
A prospective randomized controlled trial was conducted from Marc....

Results

Participant characteristics
A total of 126 patients were initially screened for eligibility between March 2024 and March 2025, of whom 80 met the inclusion criteria and were randomized into the control group (n = 40) and the MSSN+FPRT intervention group (n = 40). During follow-up, three participants (two from the control group and one from the intervention group) withdrew due to early discharge or refusal to continue, resulting in a final sample of 77 participants (control group: n = 38; intervention.......

Discussion

This study demonstrated that MSSN combined with FPRT  was associated with improved postoperative recovery in older thoracic surgery patients. Compared with routine care, the integrated intervention showed greater reduction in postoperative pain and anxiety, as well as enhancements in physical function (grip strength and 6-min walking distance) and sleep quality. These findings suggest that engaging sensory systems and involving family in rehabilitation can accelerate recovery,.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Hand dynamometer (Jamar Hydraulic Hand Dynamometer)	Patterson Medical (Performance Health)	5030J1	Standard device for grip strength measurement
G*Power software (v3.1)	Heinrich Heine University Düsseldorf	https://www.psychologie.hhu.de/arbeitsgruppen/allgemeine-psychologie-und-arbeitspsychologie/gpower
Incentive spirometer (Voldyne 5000)	Hudson RCI (Teleflex)		Used for respiratory physiotherapy
Statistical software (SPSS v26.0)	IBM	https://www.ibm.com/products/spss-statistics