A Controlled Trial of the Efficacy of a Training Walking Program in Patients Recovering from Abdominal Aortic Aneurysm Surgery

Abstract

bidity and the additional risk factors related to them contribute to a high risk of operative and postoperative complications. The main objective of the physiotherapy after abdominal surgery is to prevent and treat the postoperative complications and functional disorders resulting from the elective operation.All around the world, an increasing occurrence of abdominal aortic aneurysm has been observed, partly due to the prolongation of human life span and partly due to the development of diagnostic methods. Elective surgery is the best management of the disease [1,2]. Age, general health status, co-mor- AbstractBackground. Major surgical procedures as well as general anesthesia contribute to muscle weakness and posture instability and may result in increased postoperative complications and functional disorders resulting from an elective operation. Objectives. We aim to state the significance of backward walking as a form of interval march training with patients after abdominal aortic aneurysm surgery. Material and Methods. Sixty-five patients were randomly divided into three subgroups and three various models of physiotherapy were applied. The participants were males, aged 65-75 years, with stable cardiologic status, absence of neurological disorders, and non-symptomatic aneurysm -non-ruptured, no pain complaints and no motor system impairments. The control group had only routine physiotherapy, since therapeutic groups I and II also had walking exercises, forward in group II and backward in group I. Both experimental groups were applied interval training. The patient data analyzed was as follows: hospitalization period-days; 6-min walking test-distance (m), training heart rate (1/min), mean speed (km/h), MET; spirometry test-FVC(L), FEV1(L), FEV1/FVC and PEF(L/s).Results. The hospital stay period in all groups did not vary significantly. Statistical analysis showed that patients with backward walking had a statistically significantly lower reduction of walking distance in the corridor test when compared to the control group (p < 0.05). After the operation, a significant reduction of mean speed in the control group was noted in comparison with both the forward and backward walking groups (p < 0.05). No significant differences were noted between the experimental groups in average walking speed as well as in heart rate in all observed groups. Conclusions. Physical training applied to patients after major abdominal aortic aneurysm surgery influences sustaining the level of exercise tolerance to a small extent. Both backward and forward walking seem to be alternative methods when compared to classic post-surgery physiotherapy (Adv Clin Exp Med 2016, 25, 6, 1241-1371).

Effect of physical interventions on physical performance and physical activity in older patients during hospitalization: a systematic review

“…musculoskeletal, cardiovascular, falls) Subacute, rehabilitation ward 22, Exercise program, 80.8 (4.6) 25, Usual care, 81.6 (6.5) Within 2 days of A, < 48 h before D DEMMI s , EMS r , TUG h , BI e Good Tibaek [ 27 ] 2013 Various diagnoses (e.g. falls, respiratory, medicine) Subacute, geriatric rehabilitation ward 29, Progressive resistance strength training, 80 (6.5) 27, Usual care, 79 (7.5) Within 3 days of A, D TUG h , 30s-chair stand test, 10MWT g , BI e , Modified FAC p Good Wnuk [ 18 ] 2016 Abdominal aortic aneurysm surgery Subacute, general and vascular surgery ward 1. 15, Backward walking training, 68 (3) 2.…”

“…Load was increased by a 0.5 kg sandbag and by an elastic band with different resistance when the patient reported that the load was easy or moderate on the modified Borg Scale and could do more than 15 repetitions. 4 50 28 (15) 62.5 Wnuk [ 18 ] 2016 Physiotherapy program: consisted of education, active exercises of the upper and lower extremities and backward or forward walking on an interval training cycle. Yes, intensity of the interval training cycle was adjusted to individual patient abilities based on a stress test and a calculated training heart rate.…”

“…No positive effect was found on gait ability, measured by TUG and 10MWT [ 17 ]. A physiotherapy program with a backward walking interval training cycle had a positive effect on walking distance after surgery measured with the 6-min Walk Test (6MWT), however, the group with a forward walking interval training cycle showed no positive effect on walking distance compared with the control group [ 18 ]. Exercise programs for upper limb, lower limb and trunk and continuously adapted to the patient’s capabilities, had no positive effect on functional independence reflected by Barthel Index (BI) [ 19 , 20 ].…”

Effectiveness and safety of structured exercise vs. no exercise for asymptomatic aortic aneurysm: systematic review and meta-analysis

“…28 Finally, one study was performed in both the preoperative and postoperative periods (preoperative and postoperative study). 30 The clinical trial authors also published three other articles based on the same studies: two 25,26 from Myers et al 11 and one 27 from Barakat et al 28 Table 7 describes the studies and their characteristics, including the reasons for inclusion or exclusion. 39 ; # Text quoted from Kothmann et al 29 ; ** Text quoted from Tew et al 18 ; † † Text quoted from Myers et al 11 ; ‡ ‡ Text quoted from Barakat et al 28 .…”

A multicomponent intervention to decrease sedentary time during hospitalization: a quasi-experimental pilot study

“…A recent systematic review, concluding that the effect of physical activity interventions on physical performance in older patients during hospitalization was uncertain, included 15 trials. 8 The interventions used in those trials varied considerably and comprised (supervised) physical exercise program(s) with mobility, flexibility, strength, balance, walking and functional exercises, [9][10][11][12][13][14][15][16][17][18][19] proprioceptive neuromuscular facilitation, 20 electrical stimulation, 21 vibration training 22 and horse riding stimulation. 23 Four RCTs published afterwards [24][25][26][27] investigated one or more (supervised) physical exercise program(s) including mobility, flexibility, strength, balance, walking and functional exercises.…”