Effects of early mobilisation in patients after cardiac surgery: a systematic review

• Published in: Physiotherapy Vol. 103; no. 1; pp. 1 - 12
• Main Authors: Ramos dos Santos, P.M, Aquaroni Ricci, N, Aparecida Bordignon Suster, É, de Moraes Paisani, D, Dias Chiavegato, L
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-03-2017
• Subjects: Cardiac surgery; Cardiac Surgical Procedures - rehabilitation; Early Ambulation - methods; Early mobilisation; Humans; Intensive Care Units - statistics & numerical data; Length of Stay - statistics & numerical data; Physical Medicine and Rehabilitation; Physical Therapy Modalities; Postoperative complications; Postoperative Complications - epidemiology; Randomised control trials; Randomized Controlled Trials as Topic; Early mobilisation; Cardiac surgery; Postoperative complications; Randomised control trials
• ISSN: 0031-9406; 1873-1465
• DOI: 10.1016/j.physio.2016.08.003

Abstract Background Early mobilisation is prescribed after cardiac surgery to prevent postoperative complications, decrease length of hospital stay, and augment return to daily activities. Objective To evaluate the evidence for the effects of early mobilisation in patients after cardiac surgery on length of hospital stay, functional capacity and postoperative complications. Data sources The data sources used were Medline, Embase, CINAHL, PEDro, Web of Science and Cochrane Central Register of Controlled Trials. Study selection Randomised controlled trials of early mobilisation after cardiac surgery. Study selection was not restricted by language or publication time. Study appraisal and synthesis methods The methodological quality of each article was appraised with the PEDro scale. All review phases (selection, data extraction and appraisal) were conducted by two investigators, and a third investigator provided consensus. Results Nine trials were selected. The PEDro scale showed that the studies had a low risk of bias (range 5 to 9 points). The trials revealed diversity in techniques used for mobilisation, as well as periods considered early for the start of the intervention. Early mobilisation groups had improved outcomes compared with control groups without treatment. Generally, these advantages did not differ when groups of interventions were compared. Limitations It was not possible to perform a meta-analysis due to the variability of the interventions proposed as early mobilisation. Conclusions Regardless of the techniques used as mobilisation, the essential point is to avoid bed rest. Early mobilisation seems to be important to prevent postoperative complications, improve functional capacity and reduce length of hospital stay in patients after cardiac surgery.