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Quantifying postoperative mobilisation following oesophagectomy.

J M Hussey1, T Yang1, J Dowds2

  • 1Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Ireland.

Physiotherapy
|October 23, 2018
PubMed
Summary

Early mobilisation after oesophagectomy is limited, with patients remaining sedentary postoperatively. Haemodynamic instability, often due to thoracic epidurals, is a key barrier to increasing patient mobility.

Keywords:
Early ambulationOesophagectomyPhysiotherapy techniquesPostoperative care

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Area of Science:

  • Critical Care Medicine
  • Surgical Recovery
  • Rehabilitation Science

Background:

  • Early mobilisation is crucial for postoperative recovery after complex surgeries like oesophagectomy.
  • Evidence guiding early mobilisation protocols in critical care settings remains limited.
  • Actual postoperative mobilisation levels following oesophagectomy are not well understood.

Purpose of the Study:

  • To quantify postoperative mobilisation levels in patients undergoing oesophagectomy.
  • To identify barriers affecting mobility in the postoperative critical care setting.

Main Methods:

  • A prospective observational study was conducted in a postoperative critical care setting.
  • Thirty participants scheduled for oesophagectomy were enrolled.
  • Objective measurement of physical activity using Actigraph GT3X+ and analysis of medical records for influencing factors.

Main Results:

  • Participants spent over 96% of their time sedentary during postoperative days 1-5.
  • Light intensity activity and daily step count increased significantly from postoperative day 1 to day 5 (p<0.001).
  • Haemodynamic instability was the most frequently reported barrier to attempting or limiting mobility.

Conclusions:

  • Despite daily physiotherapy, significant challenges hinder postoperative mobilisation after oesophagectomy.
  • Haemodynamic instability, potentially linked to thoracic epidurals, is a primary limitation to early mobilisation.
  • Collaborative, goal-directed mobilisation involving the multidisciplinary team may help overcome modifiable barriers.