The effect of a single pre-operative physiotherapy session on physical function in elderly patients following abdominal surgery

Abstract

Elderly patients report a decrease in function and activities of daily living following abdominal surgery. Literature suggests that pre-operative rehabilitation may assist in the prevention of complications and may improve physical function. An education and exercise pamphlet was developed from current literature following a narrative review. The pamphlet was then used in a pilot single-blind randomised controlled trial. Outcome measures included clinical outcomes (length of hospital stay, post-operative pulmonary complications and first mobilisation uptime parameters), the DeMorton Mobility Index (DEMMI), six minute walk test (6MWT), Lawton-Brody’s instrumental activities of daily living (IADL) and the Functional Comorbidity Index (FCI). From the narrative review of the current literature, eight articles were applicable. Following a peer review the pamphlet was used in the clinical trial. Twelve participants with a mean age of 65.75 (±4.47) years were included in this pilot study. The intervention and control groups were comparable at baseline (p>0.05). Intervention participants recovered passed baseline (p=0.006) in terms of mobility (DEMMI score 79.5 (± 2.46) at baseline; 95.67 (±4.33) at four week follow-up). Recruitment was low with only 10.95% referral rate and 47.82% non-consent. This study shows that a single physiotherapy session prior to surgery could improve recovery of mobility among the high-risk elderly patients but a larger sample is needed to confirm. The feasibility of a large prehabilitation study in the current South African climate is hampered by a number of factors.