ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 26 of 45
УЖМБС 2021, 6(6): 194–199
Physical Therapy and Ergotherapy

The Influence of Approaches to Early Mobilization of Cardiosurgical Patients on the Duration of Hospitalization

Vitomskyi V. V. 1,2, Vitomska M. V. 1

The purpose of the study was to compare the impact of approaches to early mobilization of cardiac surgery patients on the duration of hospitalization. Materials and methods. Early mobilization of patients after cardiac surgery and study of its effectiveness is an important issue of physical therapy. The beginning of the development of cardiac surgery was characterized by the fact that patients after surgery were in the intensive care unit on a bed rest for several days to improve recovery and prevent complications. The benefits of early mobilization were later recognized, and patient verticalization began earlier. The study involved 90 patients (over 18 years old). Patients were divided into two groups. The first group of mobilization (GM1, n = 49) included patients who underwent surgery on Monday or Tuesday, performed standing and if possible walking on the spot on the first postoperative day with a physical therapist. The second group of mobilization (GM2, n = 41) included patients who underwent surgery on Friday, were mobilized to sit in bed on the first postoperative day; performed standing and walking on the spot on the second or third postoperative day with the participation of medical staff. In addition, other early mobilization points (chamber walking and corridor walking) were performed statistically later in GM2. Patients did not differ in other features of physical therapy. All patients were told during the preoperative consultation with a physical therapist that if they were operated on Friday, they would perform mobilization and therapeutic exercises with medical staff on weekends. Patient case data (age, sex, study protocols and operations) were studied. Results and discussion. Among GM1 patients, the part of men was 69.39%, and in the GM2 group – 78.05% (χ² = 0.856; p = 0.355). Groups of patients did not have significant differences in age, anatropometric parameters, key results of preoperative studies, characteristics of surgical interventions. The study did not establish the effect of more progressive early mobilization performed in GM1 on the length of stay in the postoperative ward (7 (6; 8) nights versus 7 (5; 8) nights; p=0.428) and the total duration of postoperative hospitalization (9 (8; 10) nights against 10 (7; 11) nights; p=0.733). Statistically better indicators of the GM1 group were obtained in the number of nights spent in intensive care (all patients – two nights, except 3 patients in GM1 and 11 in GM2 – three nights; p=0.007), but this advantage should be considered taking into account the impact of patient logistics, namely longer stay in intensive care on weekends. Conclusion. The data confirmed the same effectiveness of approaches to early mobilization of cardiac surgery patients in terms of duration of postoperative hospitalization

Keywords: physical therapy, mobilization, therapeutic exercises, cardiorehabilitation, efficiency

Full text: PDF (Ukr) 294K

  1. Castelino T, Fiore Jr JF, Niculiseanu P, Landry T, Augustin B, Feldman LS. The effect of early mobilization protocols on postoperative outcomes following abdominal and thoracic surgery: a systematic review. Surgery. 2016;159(4):991-1003.
  2. Garzon-Serrano J, Ryan C, Waak K, Hirschberg R, Tully S, Bittner EA, et al. Early mobilization in critically ill patients: patients' mobilization level depends on health care provider's profession. Pm&r. 2011;3(4):307-13.
  3. Santos PMR, Ricci NA, Suster ÉA, Paisani DM, Chiavegato LD. Effects of early mobilisation in patients after cardiac surgery: a systematic review. Physiotherapy. 2017;103(1):1-12.
  4. Floyd S, Craig SW, Topley D, Tullmann D. Evaluation of a progressive mobility protocol in postoperative cardiothoracic surgical patients. Dimens Crit Care Nurs. 2016;35(5):277-82.
  5. Surkan MJ, Gibson W. Interventions to mobilize elderly patients and reduce length of hospital stay. Canad J Cardiol. 2018;34(7):881-8.
  6. Urell C, Emtncr M, Hedenstrom H, Westerdahl E. Respiratory muscle strength is not decreased in patients undergoing cardiac surgery. J Cardiothorac Surg. 2016;11:41. PMCid: PMC4815249.
  7. Westerdahl E, Lindmark B, Almgren SO, Tenling A. Chest physiotherapy after coronary artery bypass graft surgery--a comparison of three different deep breathing techniques. J Rehabil Med. 2001 Mar;33(2):79-84.
  8. Moradian ST, Najafloo M, Mahmoudi H, Ghiasi MS. Early mobilization reduces the atelectasis and pleural effusion in patients undergoing coronary artery bypass graft surgery: A randomized clinical trial. J Vasc Nurs. 2017 Sep;35(3):141-5.
  9. Westerdahl E, Möller M. Physiotherapy-supervised mobilization and exercise following cardiac surgery: a national questionnaire survey in Sweden. J Cardiothorac Surg. 2010 Aug 25;5:67. PMCid: PMC2936289.
  10. Vitomskyi VV, Al-Hawamdeh KM, Vitomska MV, Gavreliuk SV. Porivniannia pokaznykiv terapevtychnoho aliansu za rezultatamy anketuvannia kardiokhirurhichnykh patsiientiv ta yikh fizychnykh terapevtiv [Comparison of the Therapeutic Alliance Indicators according to the Results of the Survey of Cardiosurgical Patients and their Physical Therapists]. Ukr Ž Med Bìol Sport. 2020;5(6):275-81.
  11. Vitomskyi VV, Lazarіeva OB, Doroshenko EYu, Vitomska MV, Kovalenko TМ, Hertsyk AМ, et al. The impact of mobilization protocols on the length of postoperative hospitalization among cardiac surgery patients. Zaporozhye Med J. 2021;23(2):259-265.