A mobilization poster stimulates early in-hospital rehabilitation after cardiac surgery: a prospective sequential-group study

Abstract

Background Patients infrequently mobilize at the surgical ward after cardiac surgery. Inactivity results in prolonged hospital stay, readmissions and increased cardiovascular mortality. Next, the course of in-hospital mobilization activities for patients is unclear. The aim was to evaluate early mobilization after heart surgery with a mobilization poster on the Activity Classification Guide for Inpatient Activities score from the American College for Sports Medicine (ACSM). Second, to develop a Thorax Centrum Twente (TCT) score to assess distinctive activities performed. Methods A poster was developed for the Moving is Improving! study to stimulate hospital mobilization after heart surgery. In this sequential-group study at a cardiothoracic surgery ward, 32 patients were included in the usual care group and 209 patients in the poster mobilization group. Change of ACSM and TCT scores over time were both defined as primary endpoints. Secondary endpoints included length of stay and survival. A subgroup analysis for coronary artery bypass grafting (CABG) was performed. Results ACSM score increased during hospital stay (p < 0.001). No significant increase of ACSM score was observed with a mobilization poster (p = 0.27), nor in the CABG subgroup (p = 0.15). The poster increased mobility to chair, toilet, corridor (all p < 0.01) and cycle ergometer (p = 0.02) as measured by the activity-specific TCT scores, without differences in length of stay or survival. Conclusions ACSM score measured day-to-day functional changes, without significant differences between the poster mobilization and usual care group. Actual activities measured with the TCT score did improve. The mobilization poster is now new standard care, and effects in other centers and other departments should be assessed. Trial registration This study does not fall under the ICMJE trial definition and was not registered.

Postoperative C-reactive protein levels correlate with reduced spinal column mobility after median sternotomy: a prospective cohort study

“…Therefore, the range of motion in vivo , including soft tissues and surrounding muscles, has not been examined. Furthermore, the effects of postoperative inflammation ( 15 ) and rehabilitation ( 16 ), which are known to cause perioperative complications and changes in physical function, have not been examined.…”

ECMOve: A Mobilization Device for Extracorporeal Membrane Oxygenation Patients

“…[7][8][9][10] Subsequently, active rehabilitation during ECMO progressed toward studies showing the feasibility and safety of early mobilization in ECMO patients, [11][12][13][14][15][16][17][18] and is in line with active in-hospital mobilization strategies after cardiac surgery. 19 A positive response to early mobilization during ECMO has been associated with improved clinical outcomes such as lower mortality, decreased length of hospital stay, and improved level of independence after hospital discharge. 11,[20][21][22][23] These improved patient outcomes may lead to lower hospital costs compared to nonambulatory ECMO.…”