Open Access
Subscription Access
Open Access
Subscription Access
Effect of Exercise on Functional Independence after Abdominal Surgery in the Elderly
Subscribe/Renew Journal
Aging is associated with increased prevalence of multiple diseases, with decline of the functional reserve of many organs and systems and a progressive restriction in personal and social resources. Therefore this designed to clarify the effect of exercise on recovery.
Methods and design
A prospective cohort of 174 consecutive patients recruited from General surgery department of El-Mataria Teaching Hospital, Cairo, Egypt, with 68.2±5.3 years (60 to 75 years), underwent open abdominal surgery, they were randomly divided into; Mobilizing Group (MG= 80); Nonmobilized group (NMG=75). After surgery MG participated in mobility program; range of motion exercise, sitting out of bed, trunk flexibility exercises, upper limb elevation exercise using bottles and walking exercise. Non-mobilized group (NMG=75) instructed to keep their activity level without changes. The primary assessment includes; Time Up and Go Test (TUGT), Functional reach test (FRT) and hand grip strength. There were no significant difference in TUGT, FRT, and grip strength between MG and NMG group preoperatively and at 1 and 3 weeks, postoperatively with significant decline in functional recovery.
Results and conclusion
There were significant differences at 6 weeks, 3 and 6 months postoperatively with greater improvement in functional recovery to preoperative level for mobilizing group. Surgical treatment can be offered to elderly patients 60 years old but with predictable decline in functional independence. Collaboration between surgeon and physiotherapist for establishing an effective rehabilitation program may be helpful for restoring their function independence.
Keywords
- World Health Organization (WHO). A strategy for active healthy ageing and old age care in the eastern mediterranean region 2006-2015" Cairo, World Health Organization 2006;Regional Office for the Eastern Mediterranean, Cairo.
- Leung JE, Dzankic S. Relative importance of preoperative health status versus intraoperative factors in predicting postoperative outcomes in geriatric surgical patients” J Am Geriatr Soc 2001; 49:1080- 1085.
- Lawrence VA, Hazuda H Cornel JE, et al. Functional independence after major abdominal surgery in the elderly. J Am Coll Surg 2005;199: 762-772.
- Siebens H, Aronow H, Edward D, et al. A randomized controlled trial of exercise to improve outcomes of acute hospitalization in older adults” J Am Geriatr Soc 2000; 48: 1545-1552.
- Convertino V. An overview of the issues: Physiological effects of bed rest and restricted physical activity. Med Sci Sports Exerc 1997;29:191-196.
- Fukuse T, Satoda N, Hijiyo K, et al. Importance of a comprehensive geriatric assessment in predication of complication following thoracic surgery in elderly patients. Chest 2005; 127: 886-891.
- Repetto L, Fratino L, Audisio RA. Comprehensive geriatric assessment adds information to eastern cooperative oncology group performance status in elderly caner patients: an Italian group for geriatric oncology study. J Clin Oncol 2002; 20:494-502.
- Mackay MR, Ellis E, Johnston C. Randomized clinical trial of physiotherapy after open abdominal surgery in high risk patients. Aust J Physiother 2005; 51:151-159.
- Browning L, Denehy l, Scholes RL. The quantity of early upright mobilization performed following upper abdominal surgery is low: an observational study. Aust J Physiother 2007; 53:47-52.
- Nielsen KG, Holte K, Kehlet H. Effects of position on postoperative pulmonary function. Acta Anaesthesiol Scand 2002; 47:12701275.
- Kirkeby-Garsad I, Sellevold OFM, Skogvoll SR . Mixed venous oxygen desaturation during early mobilization after coronary artery bypass surgery” Acta Anaesthesiol Scand 2005.
- Dean E. Mobilization and exercise” In: Fronfelter D, and Dean E” Cardiovascular and Pulmonary Physical Therapy: Evidence and Practice “ 4th Ed St Louis ; Mosby Elsvier 2006 pp263-306.
- Thomas SK, Humphreys KJ, Miller MD, et al., Individual nutrition therapy and exercise regime: a controlled trial of injured, vulnerable elderly. BMC geratric 2008;8: 4.
- Bourdel-Marchasson J, Joseph PA, Dehail P, et al., Functional and metabolic early changes in calf muscle occurring during nutritional repletion in malnourished elderly patients. Am J Clinic Nutria 2001;73:832-838.
- Williamson WK, Nicoloff AD, Taylor LM Jr, et al. Functional outcome after open repair of abdominal aortic aneurysm. J Vasc Surg 2001;33: 913–920.
- Muir AJ, Edwards LJ, Sanders LL, et al. A prospective evaluation of health-related quality of life after ileal pouch anal anastomosis for ulcerative colitis. Am J Gastroenterol 2001;96:1480–1485.
- Brooks D, Davis AM, Naglie C. Validity of 3 physical performance measures in inpatient geriatric rehabilitation. Arch Phys Med Rehab 2006; 87:105-110.
- Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39:142–148.
- De-Waard BP, bentrup BR, Hollman JH, et al., Relationship of functional reach and lateral reachtests in the elderly females. J Geriatr physic ther 2002; 25;4-9.
- Schaubert KL, Bohannon RW: Reliability and validity of three strength measures obtained from communitydwelling elderly persons. J Strength Cond Res 19:717-720, 2005
- A de Morton1 N, Keating1 JK, Berlowitz2 DJ, et al. Additional exercise does not change hospital or patient outcomes in older medical patients: a controlled clinical trial. Aust J Physiother 2007; 53: 105–111.
- Genaidy A., Davis N., Delgado E., Garcia S., and Al- Herzalla E., (1994): “Effect of job- simulated exercises Program on employees performing manual handling Operations: Ergonomics 73: (1):9-106.
- Hara, T, Shimada T. Effects of exercise on the improvement of the physical function of the elderly. J Phys Ther Sci 2007; 19: 15-26.
- Pesanelli KE, Cigna JA, Ba Sg, et al., Occupational Rehabilitation Following Open Mesh Surgical Repair of an Inguinal Hernia” Phys Ther 2003; 83: (1);58-66.
- Hinton PR,(2004): “Statistics Explained”2nd Ed. Routledge Taylor & Francis Group London Pp149-155.
- Williamson WK, Nicoloff AD, Taylor LM et al. Functional outcome after open repair of abdominal aortic aneurysm. J Vasc Surg 2001; 33: 913–920
- Amemiya, T, Oda K, Ando M, et al. Activities of daily living and quality of life of elderly patients after electivesurgery for gastric and colorectal cancers. Ann Surg 2007; 246: 222–228.
- Temple PC, Travis B, Sachs L, et al. Function and well being of patients before and after elective surgical procedures. J Am Coll Surg 1995; 181:17-25.
- Wu Cl, Naqibuddin M, Rowlingson AJ, et al. The effect of pain on health-related quality of life in the immediate postoperative period. Anesth Analg 2003; 97: 1078-1085.
- Ferrucci L, Guralnik JM, Studenski S, et al. Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: a consensus report. J Am Geriatr Soc2004; 52:625– 634.
- Timonen L, Rantanen T, Ryynanen OP, et al. A randomized controlled trial of rehabilitation after hospitalization in frail older women: effects on strength, balance and mobility. Scand J Med Sci Sports 2002; 12: 186–192.
- Fukanga T. An exercise program to strength a muscle” In The way to increase their function on a daily life for elderly people; the system in the community and concrete guideline” Okada M, Matsuda M, Kuno S, and et al., Tokyo: NAP, 2002 :129-132.
- Fukanga T. The meaning of the muscle strength training for the elderly people and the content of the training and the points to notice” J Clinic Sports Med. 1999; 16: 993-1001.
- Beckingham AC,Watt S. Daring to grow old: lessons in healthy aging and empowerment. BOLD,1999; 9:9.
- Sallis JF et al. Environmental and policy interventions to promote physical activity. Am J Pre Med, 1998, 15:379-97 Mohammed Taher Ahmed et al/Indian Journal of Physiotherapy and Occupational herapy. July - September 2009, Vol. 3, No. 3
Abstract Views: 406
PDF Views: 0