Department of Physiotherapy, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Department of Anesthesiology and Intensive Care, Örebro University Hospital, Örebro, Sweden.
World J Surg. 2024 Apr;48(4):956-966. doi: 10.1002/wjs.12102. Epub 2024 Feb 13.
The level of post-operative mobilization according to Enhanced Recovery After Surgery (ERAS) guidelines is not always achieved. We investigated whether immediate mobilization increases postoperative physical activity. The objective was to evaluate the effects of immediate postoperative mobilization in the post-anesthesia care unit (PACU) compared to standard care.
This randomized controlled trial, involved 144 patients, age ≥18 years, undergoing elective colorectal surgery. Patients were randomized to mobilization starting 30 min after arrival in the PACU, or to standard care. Standard care consisted of mobilization a few hours later at the ward according to ERAS guidelines. The primary outcome was physical activity, in terms of number of steps, measured with an accelerometer during postoperative days (PODs) 1-3. Secondary outcomes were physical capacity, functional mobility, time to readiness for discharge, complications, compliance with the ERAS protocol, and physical activity 1 month after surgery.
With the intention-to-treat analysis of 144 participants (median age 71, 58% female) 47% underwent laparoscopic-or robotic-assisted surgery. No differences in physical activity during hospital stay were found between the participants in the intervention group compared to the standard care group (adjusted mean ratio 0.97 on POD 1 [95% CI, 0.75-1.27], p = 0.84; 0.89 on POD 2 [95% CI, 0.68-1.16], p = 0.39, and 0.90 on POD 3 [95% CI, 0.69-1.17], p = 0.44); no differences were found in any of the other outcome measures.
Addition of the intervention of immediate mobilization to standard care did not make the patients more physically active during their hospital stay.
ClinicalTrials.gov Identifier: NTC 03357497.
根据加速康复外科（ERAS）指南，术后的活动水平并不总是能够达到。我们研究了即刻活动是否会增加术后的身体活动量。目的是评估在麻醉后护理病房（PACU）中与标准护理相比，即刻术后活动的效果。
这是一项随机对照试验，涉及 144 名年龄≥18 岁的择期结直肠手术患者。患者被随机分配到 PACU 到达后 30 分钟开始活动，或接受标准护理。标准护理包括根据 ERAS 指南在病房几小时后开始活动。主要结局是使用加速度计测量术后第 1-3 天的身体活动量，即步数。次要结局是身体能力、功能移动性、准备出院时间、并发症、ERAS 方案的依从性以及术后 1 个月的身体活动量。
在 144 名参与者（中位数年龄 71 岁，58%为女性）的意向治疗分析中，47%接受了腹腔镜或机器人辅助手术。与标准护理组相比，干预组在住院期间的身体活动量没有差异（调整后的平均比值为第 1 天 0.97 [95% CI，0.75-1.27]，p=0.84；第 2 天 0.89 [95% CI，0.68-1.16]，p=0.39，第 3 天 0.90 [95% CI，0.69-1.17]，p=0.44）；在任何其他结局指标上均未发现差异。
在标准护理的基础上增加即刻活动干预并没有使患者在住院期间更活跃。
ClinicalTrials.gov 标识符：NTC 03357497。
