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.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
50
Early mobilization: mobilization with the hospital staff begins already on the day of surgery, and includes mobilization in and out of bed, rise up from a chair, standing and walking. Intensive mobilization: mobilization more than 4 times a day in the first postoperative week.
Hvidovre University Hospital
Hvidovre, Denmark
Mobilization within 24 hours after surgery assessed by CAS
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 frame: Up to 24 hours after surgery
Time out of bed (minutes per day) assessed by a accelerometer
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.
Time frame: Up to 7 days after surgery
Mobilization 4 times a day registered in a journal
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.
Time frame: Up to 7 days after surgery
Able to complete the outcome measures: NRS, VAFS, CST, Peakflow and EQ-5D-5L
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.
Time frame: Up to 7 days after surgery
Postoperative Pulmonary complication
The occurrence of postoperative pulmonary complication defined as Clavien-Dindo classification higher than grade 1
Time frame: Up to 2 weeks after surgery
Cumulated Ambulation Score (CAS, 0-6 points)
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.
Time frame: Up to 7 days after surgery
Functional independence in Activity of Daily Living assessed by Barthel Index (BI, 0-100 points)
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.
Time frame: Up to 7 days after surgery
30-second Chair Stand Test (CST)
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.
Time frame: Up to 7 days after surgery
24-hour physical activity (minutes per day)
Accelerometer recording time spent in lying, sitting and standing/walking.
Time frame: Up to 7 days after surgery
Pulmonary function assessed by Peak flow meter
Measure of a participants maksimum speed of exspiration assessed by a peak flow meter
Time frame: Up to 7 days after surgery
Visual Analog Fatigue Scale (VAFS, 0-10 points)
Intensity of fatigue after surgery. Scale range is 0-10 points and higher scores indicate higher degree of fatigue.
Time frame: Up to 7 days after surgery
Pain assessed by Numeric Rating scale (NRS, 0-10 points)
Self-reported measure of pain intensity. Scale range is 0-10 points and higher scores indicate higher degree of pain.
Time frame: Up to 7 days after surgery
Health-related quality of life assessed by EQ-5D-5L (0-100 points)
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.
Time frame: Up to 7 days after surgery
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