Pre-operative physiotherapy for elderly patients undergoing abdominal surgery

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.