Early Mobilization Following Emergency Abdominal Surgery
- Conditions
- Acute High-risk Abdominal Surgery (AHA)
- Interventions
- Other: Early intensive mobilization
- Registration Number
- NCT03662932
- Lead Sponsor
- Morten Tange Kristensen PT, PhD
- Brief Summary
Acute High-risk abdominal surgery (AHA) is associated with high mortality rates, multiple postoperative complications and prolonged duration of hospital admission. A recent study revealed very low level of physical performance in the first postoperative week in patients undergoing AHA. Furthermore the included patients who were non-independently mobilized or had low level of 24-hour physical activity more often experienced a pulmonary complication. Studies examining the feasibility of early and intensive mobilization are needed, prior to investigating the effect of the intervention in an Randomised Controlled Trial. The purpose of this study is evaluating the feasibility of early and intensive mobilization during the first week postoperatively among patients who receive Acute High-Risk Abdominal Surgery (AHA). The aim is also to describe physical performance, physical activity, pulmonary function and health-related quality of life, as well as barriers to mobilization following AHA surgery.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 50
• Patients (18 years and older) undergoing emergency laparotomy or laparoscopy (inclusive reoperations after elective surgery).
- Patients undergoing minor emergency operations (uncomplicated appendectomy, laparoscopic cholecystectomy, diagnostic laparoscopy or laparotomy without intervention).
- Patients not able to give consent to participation in the study within 48 hours after surgery.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Early intensive mobilization Early intensive mobilization Progressed mobilization from postoperative day 0.
- Primary Outcome Measures
Name Time Method Mobilization within 24 hours after surgery assessed by CAS Up to 24 hours after surgery Percentage of participants that is mobilized within 24 hours after surgery assessed by the Cumulated Ambulation Score (CAS).
Pre-defined criteria of feasibility; \>=80% feasible, 60-79% potentially feasible, and \<60% considered not feasible.Time out of bed (minutes per day) assessed by a accelerometer Up to 7 days after surgery Percentage of participants able to meet the predefined daily targets of time out of bed (minutes per day) assessed by a accelerometer recording time spent in lying, sitting and standing/walking.
Pre-defined criteria of feasibility; \>=80% feasible, 60-79% potentially feasible, and \<60% considered not feasible.Mobilization 4 times a day registered in a journal Up to 7 days after surgery Percentage of participants mobilized 4 times a day registered by the hospital staff in a journal.
Pre-defined criteria of feasibility; \>=80% feasible, 60-79% potentially feasible, and \<60% considered not feasible.Able to complete the outcome measures: NRS, VAFS, CST, Peakflow and EQ-5D-5L Up to 7 days after surgery Percentage of participants able to complete the selected outcome measures: Numeric Rating scale (NRS), Visual Analog Fatigue Scale (VAFS), 30-second Chair Stand Test (CST), Peakflow meter and health-related quality of life EQ-5D-5L.
Pre-defined criteria of feasibility; \>=80% feasible, 60-79% potentially feasible, and \<60% considered not feasible.
- Secondary Outcome Measures
Name Time Method Visual Analog Fatigue Scale (VAFS, 0-10 points) Up to 7 days after surgery Intensity of fatigue after surgery. Scale range is 0-10 points and higher scores indicate higher degree of fatigue.
Pain assessed by Numeric Rating scale (NRS, 0-10 points) Up to 7 days after surgery Self-reported measure of pain intensity. Scale range is 0-10 points and higher scores indicate higher degree of pain.
Cumulated Ambulation Score (CAS, 0-6 points) Up to 7 days after surgery Evaluation of independence in basic mobility (in and out of bed, rise from a chair and walking). Scale range is 0-6 points: 0 points indicate that the participant can't be mobilized and 6 points indicate that the participant is mobilizied independently.
30-second Chair Stand Test (CST) Up to 7 days after surgery Test for lower body leg strength and endurance assessed by the 30-second Chair Stand Test (CST). Record the number of times the patient stands in 30 sec.
Functional independence in Activity of Daily Living assessed by Barthel Index (BI, 0-100 points) Up to 7 days after surgery Measure functional independence in Activity of Daily Living (ADL) in relation to transfer, mobility, stairs, dressing, feeding, grooming, bathing, toilet use and bowels and bladder function. Scale range is 0-100 points and lower scores indicates increased disability.
24-hour physical activity (minutes per day) Up to 7 days after surgery Accelerometer recording time spent in lying, sitting and standing/walking.
Postoperative Pulmonary complication Up to 2 weeks after surgery The occurrence of postoperative pulmonary complication defined as Clavien-Dindo classification higher than grade 1
Pulmonary function assessed by Peak flow meter Up to 7 days after surgery Measure of a participants maksimum speed of exspiration assessed by a peak flow meter
Health-related quality of life assessed by EQ-5D-5L (0-100 points) Up to 7 days after surgery Standardized instrument developed by the EuroQol Group as a measure of self-reported health-related quality of life. Scale range is 0-100 points: 0 points indicating the worst health the participant can imagine.
Trial Locations
- Locations (1)
Hvidovre University Hospital
🇩🇰Hvidovre, Denmark