The Effect of Abdominal Support on Functional Outcomes in Patients Following Major Abdominal Surgery: A Randomized Controlled Trial

被引:50
作者
Cheifetz, Oren [3 ]
Lucy, S. Deborah [1 ]
Overend, Tom J.
Crowe, Jean [2 ]
机构
[1] Univ Western Ontario, Sch Phys Therapy, Elborn Coll, Fac Hlth Sci, London, ON N6G 1H1, Canada
[2] McMaster Univ, Sch Rehabil Sci, Hamilton, ON, Canada
[3] Hamilton Hlth Sci, Hamilton, ON, Canada
关键词
abdominal binder; abdominal surgery; Adapted Symptom Distress Scale; pain; 6-minute walk test; POSTOPERATIVE PULMONARY COMPLICATIONS; HIGH-RISK; BREATHING EXERCISES; WALK TEST; PAIN; PHYSIOTHERAPY; RESECTION; PREVENTION; IMPROVE; BYPASS;
D O I
10.3138/physio.62.3.242
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
Purpose: Immobility and pain are modifiable risk factors for development of venous thromboembolism and pulmonary morbidity after major abdominal surgery (MAS). The purpose of this study was to investigate the effect of abdominal incision support with an elasticized abdominal binder on postoperative walk performance (mobility), perceived distress, pain, and pulmonary function in patients following MAS. Methods: Seventy-five patients scheduled to undergo MAS via laparotomy were randomized to experimental (binder) or control (no binder) groups. Sixty (33 male, 27 female; mean age 58 +/- 14.9 years) completed the study. Preoperative measurements of 6-minute walk test (6MWT) distance, perceived distress, pain, and pulmonary function were repeated 1, 3, and 5 days after surgery. Results: Surgery was associated with marked postoperative reductions (p < 0.001) in walk distance (similar to 75-78%, day 3) and forced vital capacity (35%, all days) for both groups. Improved 6MWT distance by day 5 was greater (p < 0.05) for patients wearing a binder (80%) than for the control group (48%). Pain and symptom-associated distress remained unchanged following surgery with binder usage, increasing significantly (p < 0.05) only in the no binder group. Conclusion: Elasticized abdominal binders provide a non-invasive intervention for enhancing recovery of walk performance, controlling pain and distress, and improving patients' experience following MAS.
引用
收藏
页码:242 / 253
页数:12
相关论文
共 45 条
[1]  
[Anonymous], 1987, Am Rev Respir Dis, V136, P1285
[2]  
[Anonymous], ANESTHESIOL CLIN N A
[3]   Preoperative evaluation for postoperative pulmonary complications [J].
Arozullah, AM ;
Conde, MV ;
Lawrence, VA .
MEDICAL CLINICS OF NORTH AMERICA, 2003, 87 (01) :153-+
[4]   Accelerated postoperative recovery programme after colonic resection improves physical performance, pulmonary function and body composition [J].
Basse, L ;
Raskov, HH ;
Jakobsen, DH ;
Sonne, E ;
Billesbolle, P ;
Hendel, HW ;
Rosenberg, J ;
Kehlet, H .
BRITISH JOURNAL OF SURGERY, 2002, 89 (04) :446-453
[5]  
Brooks D., 2001, Physiother Can, V53, P9
[6]   POSTOPERATIVE ATELECTASIS AND PNEUMONIA [J].
BROOKSBRUNN, JA .
HEART & LUNG, 1995, 24 (02) :94-115
[7]   Predictors of postoperative pulmonary complications following abdominal surgery [J].
BrooksBrunn, JA .
CHEST, 1997, 111 (03) :564-571
[8]   POSTOPERATIVE PULMONARY COMPLICATIONS AND LUNG-FUNCTION IN HIGH-RISK PATIENTS - A COMPARISON OF 3 PHYSIOTHERAPY REGIMENS AFTER UPPER ABDOMINAL-SURGERY IN GENERAL-ANESTHESIA [J].
CHRISTENSEN, EF ;
SCHULTZ, P ;
JENSEN, OV ;
EGEBO, K ;
ENGBERG, M ;
GRON, I ;
JUHL, B .
ACTA ANAESTHESIOLOGICA SCANDINAVICA, 1991, 35 (02) :97-104
[9]   ATS statement: Guidelines for the six-minute walk test [J].
Crapo, RO ;
Casaburi, R ;
Coates, AL ;
Enright, PL ;
MacIntyre, NR ;
McKay, RT ;
Johnson, D ;
Wanger, JS ;
Zeballos, RJ ;
Bittner, V ;
Mottram, C .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2002, 166 (01) :111-117
[10]  
Denehy L, 2001, Physiother Res Int, V6, P236, DOI 10.1002/pri.231