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Ambulation Orderlies and Recovery After Cardiac Surgery: A Pilot Randomized Controlled Trial.

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Summary
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An ambulation orderly (AO) did not significantly increase post-surgery step counts in cardiac patients. While patients showed functional recovery, the AO intervention had minimal impact, suggesting future trials need different designs.

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Area of Science:

  • Cardiovascular Surgery
  • Physical Therapy
  • Patient Recovery

Background:

  • Post-operative recovery strategies are crucial for patient outcomes.
  • An ambulation orderly (AO) is a potential intervention to increase patient physical activity.
  • The impact of an AO on surgical recovery remains largely unknown.

Purpose of the Study:

  • To evaluate the effectiveness of an ambulation orderly (AO) in enhancing physical activity and functional recovery after cardiac surgery.
  • To establish effect sizes and measure variability in patient activity levels.

Main Methods:

  • Randomized controlled trial comparing AO intervention with usual care in post-operative cardiac surgical patients.
  • Primary outcomes included average daily step count, 6-minute walk test (6MWT) distance, and functional independence (Barthel Index).

Main Results:

  • Patients demonstrated significant improvements in 6MWT distance and Barthel Index from baseline to discharge.
  • Each additional ambulation barrier (e.g., oxygen, IV pole) decreased daily step count by 330 steps.
  • The AO intervention showed a small difference in daily step counts (2718 vs. 2541 steps/day), with a need for 608 patients in a larger trial.

Conclusions:

  • Significant in-hospital physical and functional recovery was observed post-surgery.
  • The ambulation orderly (AO) intervention yielded only marginal increases in daily step counts.
  • Future research should explore stepped-wedge or cluster trial designs to optimize intervention effectiveness.