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Permanent link (DOI): https://doi.org/10.7939/R3TX35J9B

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EASE-BE-FIT: Elder-Friendly Approaches to the Surgical Environment Bedside Reconditioning for Functional Improvements An Innovative Reconditioning Program for Elderly Emergency Abdominal Surgery Patients Open Access

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Other title
Subject/Keyword
Senior
Rehabilitation
Surgery
Elderly
Exercise
Type of item
Thesis
Degree grantor
University of Alberta
Author or creator
McComb, Alyssa D
Supervisor and department
McNeely, Margaret (Physical Therapy)
Khadaroo, Rachel (Surgery)
Examining committee member and department
Pituskin, Edith (Nursing)
Haykowsky, Mark (Physical Therapy)
Department
Faculty of Rehabilitation Medicine
Specialization
Rehabilitation Science
Date accepted
2016-11-25T13:39:30Z
Graduation date
2017-06:Spring 2017
Degree
Master of Science
Degree level
Master's
Abstract
Introduction: Elderly individuals who are hospitalized due to emergency abdominal surgery spend on average over 80% of their recovery time in bed, resulting in early and rapid muscle loss. As these elderly individuals have a lower physiological reserve, the impact of muscle wasting on function may be profound. Rehabilitation interventions have the potential to attenuate declines in muscle loss and optimize function. Current practices following emergency abdominal surgery, however, place little emphasis on post-surgical rehabilitation. Objectives: To examine the post-operative functional status of elderly abdominal surgery patients and to assess whether an independently led reconditioning program could increase patient physical function on discharge. Methods: A controlled before and after study using a prospective cohort of patients aged ≥65 years enrolled in the Elder-Friendly Approaches to the Surgical Environment (EASE) study. Patient function was assessed using the 30-second Sit-To-Stand (STS) on post-operative day 2 (POD2) and at discharge. On admission, patients were classified with the Rockwood Clinical Frailty Scale. Control participants were compared to intervention participants who performed the reconditioning program every day until discharge. ii Results: 72 patients with a mean age of 76.2 participated in the study. No significant differences were found in patient complication rates between the groups. Patients in the intervention group (n = 36) improved significantly more (p=0.04) than control participants (n =36), with a mean change of an additional 1.4 stands. Patients in the intervention group also spent an average of 2.1 days less in hospital than their control counterparts (p = 0.03). Conclusions: An independently led reconditioning program appears effective in improving the functional outcomes of elderly emergency abdominal surgery patients. Future studies are needed to better assess patient adherence to self- directed exercise. Strategies to enhance patient support and increased supervision of exercise are likely to result in even greater physical functioning outcomes and potentially reducing overall healthcare costs.
Language
English
DOI
doi:10.7939/R3TX35J9B
Rights
This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for the purpose of private, scholarly or scientific research. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
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