Randomised Clinical Trial

Pre-operative physiotherapy for elderly patients undergoing abdominal surgery

Rozelle Labuschagne, Ronel Roos
South African Journal of Physiotherapy | Vol 78, No 1 | a1782 | DOI: https://doi.org/10.4102/sajp.v78i1.1782 | © 2022 Rozelle Labuschagne, Ronel Roos | This work is licensed under CC Attribution 4.0
Submitted: 02 February 2022 | Published: 27 September 2022

About the author(s)

Rozelle Labuschagne, Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and Department of Physiotherapy, University of Pretoria, Pretoria, South Africa
Ronel Roos, Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Abstract

Background: Elderly patients report a decrease in function and activities of daily living following abdominal surgery. The objectives of our pilot study were to determine the effects of a single pre-operative physiotherapy session consisting of education and exercise on clinical and physical function outcomes in elderly patients.

Methods/design: A single-blind pilot randomised controlled trial evaluated clinical and functional outcomes of elderly patients following surgery in a private hospital in Pretoria, South Africa. The outcomes included length of hospital stay (LOS), postoperative pulmonary complications (PPC), first mobilisation uptime, DeMorton Mobility Index (DEMMI), 6-minute walk test (6MWT), Lawton–Brody’s instrumental activities of daily living (IADL) and the Functional Comorbidity Index (FCI). Descriptive and inferential statistics were undertaken, and statistical significance was set at p ≤ 0.05.

Discussion: Twelve participants (n = 11 female [91.67%] and n = 1 [8.33%] male) with a mean age of 65.75 (±4.47) years were included. Most participants (n = 10, 83.33%) underwent lower abdominal laparotomy (n = 10, 83.33%). The median hospital LOS was n = 4 (IQR 3.25–4) days; walking distance at first mobilisation was 130 m (IQR (85–225), with intervention participants walking further (intervention: 177 m, IQR 100–242.50; control: 90, IQR 60 m – 245 m; p = 0.59). Recruitment was low, with only 10.95% referrals and 47.82% nonconsents.

Conclusion: A single physiotherapy session prior to surgery demonstrated a potential favourable change in elderly patients’ mobility postoperatively; however, further research is necessary.

Clinical implication: A once-off pre-operative physiotherapy session could enhance recovery in elderly patients.

Trial registration: Pan African Clinical Trial Registry, PACTR201809874713904, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3593


Keywords

abdominal surgery; DEMMI; elderly; function; pre-operative; prehabilitation; physiotherapy; 6-minute walk test

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