A mobilization poster stimulates early in-hospital rehabilitation after cardiac surgery: a prospective sequential-group study
Abstract Background Patients infrequently mobilize at the surgical ward after cardiac surgery. Inactivity results in prolonged hospital stay, readmissions and increased cardiovascular mortality. Next, the course of in-hospital mobilization activities for patients is unclear. The aim was to evaluate...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-023-02173-w |
| _version_ | 1827982829684785152 |
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| author | Frank R. Halfwerk Nicole Wielens Stephanie Hulskotte Marjolein Brusse-Keizer Jan G. Grandjean |
| author_facet | Frank R. Halfwerk Nicole Wielens Stephanie Hulskotte Marjolein Brusse-Keizer Jan G. Grandjean |
| author_sort | Frank R. Halfwerk |
| collection | DOAJ |
| description | Abstract Background Patients infrequently mobilize at the surgical ward after cardiac surgery. Inactivity results in prolonged hospital stay, readmissions and increased cardiovascular mortality. Next, the course of in-hospital mobilization activities for patients is unclear. The aim was to evaluate early mobilization after heart surgery with a mobilization poster on the Activity Classification Guide for Inpatient Activities score from the American College for Sports Medicine (ACSM). Second, to develop a Thorax Centrum Twente (TCT) score to assess distinctive activities performed. Methods A poster was developed for the Moving is Improving! study to stimulate hospital mobilization after heart surgery. In this sequential-group study at a cardiothoracic surgery ward, 32 patients were included in the usual care group and 209 patients in the poster mobilization group. Change of ACSM and TCT scores over time were both defined as primary endpoints. Secondary endpoints included length of stay and survival. A subgroup analysis for coronary artery bypass grafting (CABG) was performed. Results ACSM score increased during hospital stay (p < 0.001). No significant increase of ACSM score was observed with a mobilization poster (p = 0.27), nor in the CABG subgroup (p = 0.15). The poster increased mobility to chair, toilet, corridor (all p < 0.01) and cycle ergometer (p = 0.02) as measured by the activity-specific TCT scores, without differences in length of stay or survival. Conclusions ACSM score measured day-to-day functional changes, without significant differences between the poster mobilization and usual care group. Actual activities measured with the TCT score did improve. The mobilization poster is now new standard care, and effects in other centers and other departments should be assessed. Trial registration This study does not fall under the ICMJE trial definition and was not registered. |
| first_indexed | 2024-04-09T22:38:22Z |
| format | Article |
| id | doaj.art-90848576c5724258a6dcca81ad4a0759 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-09T22:38:22Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-90848576c5724258a6dcca81ad4a07592023-03-22T12:20:22ZengBMCJournal of Cardiothoracic Surgery1749-80902023-03-0118111110.1186/s13019-023-02173-wA mobilization poster stimulates early in-hospital rehabilitation after cardiac surgery: a prospective sequential-group studyFrank R. Halfwerk0Nicole Wielens1Stephanie Hulskotte2Marjolein Brusse-Keizer3Jan G. Grandjean4Department of Cardio-Thoracic Surgery, Thorax Centrum Twente, Medisch Spectrum TwenteDepartment of Cardio-Thoracic Surgery, Thorax Centrum Twente, Medisch Spectrum TwenteDepartment of Cardio-Thoracic Surgery, Thorax Centrum Twente, Medisch Spectrum TwenteMedical School, Medisch Spectrum TwenteDepartment of Cardio-Thoracic Surgery, Thorax Centrum Twente, Medisch Spectrum TwenteAbstract Background Patients infrequently mobilize at the surgical ward after cardiac surgery. Inactivity results in prolonged hospital stay, readmissions and increased cardiovascular mortality. Next, the course of in-hospital mobilization activities for patients is unclear. The aim was to evaluate early mobilization after heart surgery with a mobilization poster on the Activity Classification Guide for Inpatient Activities score from the American College for Sports Medicine (ACSM). Second, to develop a Thorax Centrum Twente (TCT) score to assess distinctive activities performed. Methods A poster was developed for the Moving is Improving! study to stimulate hospital mobilization after heart surgery. In this sequential-group study at a cardiothoracic surgery ward, 32 patients were included in the usual care group and 209 patients in the poster mobilization group. Change of ACSM and TCT scores over time were both defined as primary endpoints. Secondary endpoints included length of stay and survival. A subgroup analysis for coronary artery bypass grafting (CABG) was performed. Results ACSM score increased during hospital stay (p < 0.001). No significant increase of ACSM score was observed with a mobilization poster (p = 0.27), nor in the CABG subgroup (p = 0.15). The poster increased mobility to chair, toilet, corridor (all p < 0.01) and cycle ergometer (p = 0.02) as measured by the activity-specific TCT scores, without differences in length of stay or survival. Conclusions ACSM score measured day-to-day functional changes, without significant differences between the poster mobilization and usual care group. Actual activities measured with the TCT score did improve. The mobilization poster is now new standard care, and effects in other centers and other departments should be assessed. Trial registration This study does not fall under the ICMJE trial definition and was not registered.https://doi.org/10.1186/s13019-023-02173-wCardiac rehabilitationEarly ambulationExercisePhysical therapyThoracic surgery |
| spellingShingle | Frank R. Halfwerk Nicole Wielens Stephanie Hulskotte Marjolein Brusse-Keizer Jan G. Grandjean A mobilization poster stimulates early in-hospital rehabilitation after cardiac surgery: a prospective sequential-group study Journal of Cardiothoracic Surgery Cardiac rehabilitation Early ambulation Exercise Physical therapy Thoracic surgery |
| title | A mobilization poster stimulates early in-hospital rehabilitation after cardiac surgery: a prospective sequential-group study |
| title_full | A mobilization poster stimulates early in-hospital rehabilitation after cardiac surgery: a prospective sequential-group study |
| title_fullStr | A mobilization poster stimulates early in-hospital rehabilitation after cardiac surgery: a prospective sequential-group study |
| title_full_unstemmed | A mobilization poster stimulates early in-hospital rehabilitation after cardiac surgery: a prospective sequential-group study |
| title_short | A mobilization poster stimulates early in-hospital rehabilitation after cardiac surgery: a prospective sequential-group study |
| title_sort | mobilization poster stimulates early in hospital rehabilitation after cardiac surgery a prospective sequential group study |
| topic | Cardiac rehabilitation Early ambulation Exercise Physical therapy Thoracic surgery |
| url | https://doi.org/10.1186/s13019-023-02173-w |
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