Effectiveness of a First Mobilization Protocol in Patients Undergoing Knee Arthroplasty: A Randomized Contolled Trial

First mobilization plays a critical role in reducing and preventing common postoperative complications such as atelectasis, deep vein thrombosis, and constipation following arthroplasty. However, many patients experience substantial fear and anxiety related to their first postoperative mobilization. Kinesiophobia associated with fear of movement may negatively affect patients' quality of life and delay the mobilization process. Consequently, avoidance of mobilization can lead to decreased physical activity and functional independence, resulting in increased dependency on others. In this context, nurses play a crucial role in alleviating patients' fears, ensuring a safe mobilization process, and enhancing motivation. Therefore, the aim of this study was to evaluate the effectiveness of a first mobilization protocol developed for patients undergoing total knee arthroplasty.

This was a single-center, parallel-group, single-blind randomized controlled trial.

The study sample consisted of 78 patients (control: 39, intervention: 39). The study was conducted at the Orthopedics and Traumatology Clinic of one of the University Health Research and Application Centers (blinded for peer review). Data were collected via the Patient Information Form, State-Trait Anxiety Inventory, Tampa Kinesiophobia Scale, and First Mobilization-Related Symptoms Assessment Form. Additionally, the first mobilization protocol was applied to the intervention group. The data obtained from the participants were analyzed via SPSS 26.0 software. Statistical significance was set at p<0.05.

The degree of feeling ready for first standing was greater in the intervention group than in the control group. Participants in the intervention group completed both the first and last mobilization in a shorter time and had lower levels of anxiety, stress, fear of falling, and fear of being unable to walk or move, with statistically significant differences observed between the groups.

The first mobilization protocol applied to patients who underwent knee arthroplasty was effective in terms of their ability to feel ready, mobilization time, anxiety, stress, fear of falling, and fear of not being able to walk/move. The application of the first mobilization protocol developed by orthopedics and trauma nurses to patients undergoing knee arthroplasty should be expanded.

This study was retrospectively registered at Clinicaltrials.gov on 12.03.2024 (Clinical Trials ID: NCT06268899).