Effects of Early Mobilization in Postoperative Elderly Patients Undergoing an Elective Abdominal Surgery

Functional decline is a common threat to elderly hospitalized patients. Immobility is one of the major contributors lead to decreased muscle strength, atelectasis, and functional decline. For elderly patients undergoing abdominal surgery, risks for these threats are even greater. The purpose of this study was to test the effect of an early mobilization protocol in postoperative elderly patients undergoing an elective abdominal surgery. A pre-and post controlled clinical trial design was employed with the subjects enrolled during 8/2007 to 4/2008 served as the control group (n=71) and subjects enrolled since 5/2008 served as the experimental group (n=37). In total, 108 subjects aged 65 years and older who scheduled for an elective abdominal surgery with expected postoperative length of stay over 5 days were enrolled from a 2000-bed medical center in Taipei, Taiwan. For the experimental group, a daily standardized 20-minute early mobilization protocol was conducted by a research nurse trained for the project until patient discharge. Subjects in the control group received usual care. The major outcome measures included hand grip strength, and activities of daily function measured by Barthel Index, A P value of less than 0.05 was considered significant.he results showed that patients at experimental group had significant less decline in Barthel index during hospitalization (12.5 ± 10.5 vs. 28.0 ± 10.5 points, p < 0.001) and better hand grip strength at discharge (24.6 ± 7.8 kg vs. 20.6 ± 8.2 kg, p = 0.03), compared to the control group. In addition, the postoperative length of stay in the experimental group was significantly shorter than the control group (13.2 ± 6.4 vs. 17.6 ± 16.2 days, p < 0.05). This early mobilization intervention is shown to be feasible and effective in reducing functional decline for elderly patients who undergoing an elective abdominal surgery.