{"title":"老年腹部手术患者术前物理治疗。","authors":"Rozelle Labuschagne, Ronel Roos","doi":"10.4102/sajp.v78i1.1782","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods/design: </strong>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 <i>p</i> ≤ 0.05.</p><p><strong>Discussion: </strong>Twelve participants (<i>n</i> = 11 female [91.67%] and <i>n</i> = 1 [8.33%] male) with a mean age of 65.75 (±4.47) years were included. Most participants (<i>n</i> = 10, 83.33%) underwent lower abdominal laparotomy (<i>n</i> = 10, 83.33%). The median hospital LOS was <i>n</i> = 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; <i>p</i> = 0.59). Recruitment was low, with only 10.95% referrals and 47.82% nonconsents.</p><p><strong>Conclusion: </strong>A single physiotherapy session prior to surgery demonstrated a potential favourable change in elderly patients' mobility postoperatively; however, further research is necessary.</p><p><strong>Clinical implication: </strong>A once-off pre-operative physiotherapy session could enhance recovery in elderly patients.</p><p><strong>Trial registration: </strong>Pan African Clinical Trial Registry, PACTR201809874713904, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3593.</p>","PeriodicalId":44180,"journal":{"name":"South African Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9575366/pdf/","citationCount":"1","resultStr":"{\"title\":\"Pre-operative physiotherapy for elderly patients undergoing abdominal surgery.\",\"authors\":\"Rozelle Labuschagne, Ronel Roos\",\"doi\":\"10.4102/sajp.v78i1.1782\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods/design: </strong>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 <i>p</i> ≤ 0.05.</p><p><strong>Discussion: </strong>Twelve participants (<i>n</i> = 11 female [91.67%] and <i>n</i> = 1 [8.33%] male) with a mean age of 65.75 (±4.47) years were included. Most participants (<i>n</i> = 10, 83.33%) underwent lower abdominal laparotomy (<i>n</i> = 10, 83.33%). The median hospital LOS was <i>n</i> = 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; <i>p</i> = 0.59). Recruitment was low, with only 10.95% referrals and 47.82% nonconsents.</p><p><strong>Conclusion: </strong>A single physiotherapy session prior to surgery demonstrated a potential favourable change in elderly patients' mobility postoperatively; however, further research is necessary.</p><p><strong>Clinical implication: </strong>A once-off pre-operative physiotherapy session could enhance recovery in elderly patients.</p><p><strong>Trial registration: </strong>Pan African Clinical Trial Registry, PACTR201809874713904, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3593.</p>\",\"PeriodicalId\":44180,\"journal\":{\"name\":\"South African Journal of Physiotherapy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9575366/pdf/\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"South African Journal of Physiotherapy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4102/sajp.v78i1.1782\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"South African Journal of Physiotherapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4102/sajp.v78i1.1782","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"REHABILITATION","Score":null,"Total":0}
Pre-operative physiotherapy for elderly patients undergoing abdominal surgery.
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.