Physiotherapy Based on PNF Concept for Elderly People After Conventional Colon Surgery

Abstract

Major abdominal surgery decrees efficiency of walking and lung ventilation after 65 year old in early postoperative period. Some techniques of the PNF concept used in improving older patients after the MAS may favourably affect the postoperative increase independence and reduce the time of hospitalization.

Early inpatient rehabilitation for acutely hospitalized older patients: a systematic review of outcome measures

“…(total sample, stroke/cardiopulmonary patients), ↑ (others)- Absolute improvement in Barthel Index: n.s. (total sample, stroke patients, others), ↑ (cardiopulmonary patients)Feasibility:- Missing data: Barthel Index = 0% (admission), 6% (discharge)Blanc-Bisson 2008 [33]France n = 76Mean age: 85 yrs.Females: n = 55 (72%);Patients with acute medical illnessIntervention:- Additional early physiotherapy (start: day 1 or 2, 2 times/day for 30 min, 5 days/week),- Focus on leg extension exercises in the upright position- Nutritional supplementsControl:- Walking with/without technical assistance or human help (start: day 3 to 6, 3 times/week until discharge)- Nutritional supplements- Physical therapy at home for 1 monthMOB: Handgrip strength (handheld dynamometry) FCT: Katz ADL Index BPN: Body weight, energy intake, protein intake, calf and arm circumferences, triceps skin fold, biochemical measures (serum albumin, C-reactive protein)AdmissionClinical stable conditionChanges from admission to clinical stable situation in total sample (time effect):- Katz ADL Index: ↓Feasibility:- Missing data: Katz ADL Index = 0%Brown 2016 [34]USA n = 100Mean age: 74 yrs.Females: n = 3 (3%)Patients with acute medical illnessIntervention:- Additional mobility protocol: Starting with basic transfers with progress to ambulation if tolerated (2 times/day, 15–20 min, 7 days/week)- Patients were encouraged to walk at each session- Physical activity behavioral strategy: goal setting, diary and interview to increase times out of bedControl: Usual care (physical therapy had to be ordered by physicians) FCT: Modified Katz ADL Index HU: LOS, physical therapy ordered during hospitalizationACE: FallsAdmissionDischargeBetween-group differences at discharge:- Modified Katz ADL Index: n.s.Changes during hospitalization in total sample:- Katz ADL Index: n.s.Group × time interaction during hospitalization:- Katz ADL Index: n.s.Feasibility:- Katz ADL Index: mean admission score in both groups was within the best 15% of the rating scale → ceiling effectCzyzewski 2013 [35]Poland n = 34Mean age: 76 yrs.Females: n = 14 (41%);Patients with major abdominal surgeryIntervention:- Usual care with a modified exercise component based on the Proprioceptive Neuromuscular Facilitation concept (30 min/day)Control: Usual care (30 min/day) MOB: 10MWT, TUG FCT: Lawton IADL scale MOB: UCLA scale, PPSA BPN: Forced ventilation capacity, first-second forced expiratory volume, maximal expiratory flow (spirometry)HU: LOS3 days prior surgery4 days after surgeryWithin-group changes from 3 days prior surgery to 4 days after surgery:- 10MWT, TUG: ↓ in both groups- Lawton IADL scale, UCLA, PPSA: NABetween-group differences 4 days after surgery:- PPSA: ↑- 10MWT, TUG: NAFeasibility:- Lawton IADL scale: mean admission score of the sample was within the best 15% of the rating scale → ceiling effect- Missing data (3 days prior & 4 days after surgery): 10MWT, TUG = 9%, SAP = 0%, UCLA, IADL: NAEyres 2005 [36]Australia n = 15Mean age: 80 yrs.Females: n = 9 (60%);Patients with acute medical illnessIntervention:- Daily additional occupational therapy- Self-care program (ADL), IADL training (e.g., cooking, laundry, café visits), community mobility (e.g., walking outdoors)Control: Usual care FCT: FIM PSY: Self-Efficacy Gauge, Life Satisfaction Index HU: LOS, use of allied health serv...…”

“…High methodological quality and low risk of bias were found for 17 studies (70.8%), with a PEDro score of > 5 points [27, 31, 32, 34, 39–46, 48, 49, 51–53]. Seven studies (29.2%) did not exceed a score of 5 points, indicating a low methodological quality and high risk of bias [33, 35–37, 47, 50, 54]. The detailed quality scores on the PEDro scale for each RCT are provided in Additional file 3: Table S2.…”

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

“… Yes, intensity of the exercises increased gradually during the training and was adapted to individual patient abilities. 5 30 20 66 Czyzewski [ 17 ] 2013 Physiotherapy based on elements of proprioceptive neuromuscular facilitation: respiratory exercises and change of position using manual resistance on sternum, upper and lower limbs, repeated initial stretch and bilateral symmetric moving standards of shoulder girdle and upper limbs. Yes, exercises were individualized with an intensity in the range of 40–50% of maximal frequency of heart rate, and instructions for individual practice were provided.…”

“…Physiotherapy based on elements of proprioceptive neuromuscular facilitation showed a positive result on return of functional independence of basic movement activities after surgery measured by the scale of independent postoperative patient’s activity. 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 ].…”

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.…”