Effect of Early Rehabilitation on Recovery Following Abdominal Hysterectomy
Study Details
Study Description
Brief Summary
Variety of physical therapy treatments have been used after open abdominal surgery to improve cardiopulmonary and physical function as well as to reduce the incidence of postoperative pulmonary complications. This study intends to determine the effect of early physical therapy interventions on post-operative recovery profile, post-operative ileus and incisional pain following abdominal hysterectomy.
Condition or Disease | Intervention/Treatment | Phase |
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N/A |
Detailed Description
This study is randomized controlled trial which will be conducted at in-patient gynecology department of Pakistan Railway hospital. This study would include total of 42 participants divided into two groups with 21 participants in each group calculated through OpenEpi (CI=95%Power=80%). Individuals will be screened according to inclusion and exclusion criteria and allocated randomly into two groups through sealed envelope method. Experimental group will receive early physical therapy interventions including patient education, ambulation, in-bed exercises, deep breathing exercises, connective tissue manipulation and TENS during the first 3 post-operative days following abdominal hysterectomy. While the control group will receive patient education and early ambulation during the first 3 post-operative days following abdominal hysterectomy.
Post-operative recovery will be assessed on 3rd post-operative day. Intensity of pain will be measured on baseline and 3rd post-operative day. The effect of intervention on post-operative ileus will be measured by monitoring each participant's time to tolerance of oral diet, first passage of stool and flatus
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Advanced Rehab Group The experimental group will receive early physical therapy interventions including patient education, ambulation, in-bed exercises, deep breathing exercises, connective tissue manipulation and TENS during the first 3 post-operative days following abdominal hysterectomy |
Other: Advanced early Rehabilitation Program
Patient education, Ambulation, In bed exercises, Deep breathing exercises: (5 rep x 3set), Connective tissue manipulation for intestinal motility (5 min) and TENS* for incisional pain (30min)
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Active Comparator: Early ambulation Group Participants of this group will receive patient education and early ambulation during the first 3 post-operative days following abdominal hysterectomy |
Other: Early ambulation
Patient education & Assisted ambulation out of bed including walking away from bedside for at least 15 min gradually moving to Unsupervised ambulation for 30 min
|
Outcome Measures
Primary Outcome Measures
- Postoperative recovery profile questionnaire [Post 3rd day]
For hospitalized patients a 17-item version of the PRP will be used (excluding the items "Re-establishing everyday life" and "Sexual activity"). The global score ranges from 0 to 17.
- Numeric pain rating scale (NPRS) [Baseline]
Numeric pain rating scale (NPRS) will be used for evaluating intensity of the incisional pain. Its scores range from 0-10, 0 means No pain and 10 means Severe pain. Patient will be asked to verbally report the pain score.
- Numeric pain rating scale (NPRS) [Post 3rd day]
Numeric pain rating scale (NPRS) will be used for evaluating intensity of the incisional pain. Its scores range from 0-10, 0 means No pain and 10 means Severe pain. Patient will be asked to verbally report the pain score.
Eligibility Criteria
Criteria
Inclusion Criteria:
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open abdominal hysterectomy
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Patient awake and responsive, stable blood pressure, stable heart rate, no dyspnea at rest and pain score < 8 on visual analogue scale on first post-operative day.
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No limitation on physical activities due to any medical problem or restriction by the physician.
Exclusion Criteria:
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Other hysterectomy procedures i.e. laparoscopic or vaginal hysterectomy.
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Females with diabetes or cancer of metastatic nature.
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Neurological or cognitive deficit.
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Ongoing respiratory problem prior to initiation of physical therapy session.
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Medical recommendation not to participate in early active rehabilitation
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Pakistan Railway hospital | Rawalpindi | Punjab | Pakistan | 44000 |
Sponsors and Collaborators
- Riphah International University
Investigators
- Principal Investigator: Huma Riaz, Riphah International University
Study Documents (Full-Text)
None provided.More Information
Publications
- Allvin R, Svensson E, Rawal N, Ehnfors M, Kling AM, Idvall E. The Postoperative Recovery Profile (PRP) - a multidimensional questionnaire for evaluation of recovery profiles. J Eval Clin Pract. 2011 Apr;17(2):236-43. doi: 10.1111/j.1365-2753.2010.01428.x. Epub 2010 Sep 16.
- Castelino T, Fiore JF Jr, Niculiseanu P, Landry T, Augustin B, Feldman LS. The effect of early mobilization protocols on postoperative outcomes following abdominal and thoracic surgery: A systematic review. Surgery. 2016 Apr;159(4):991-1003. doi: 10.1016/j.surg.2015.11.029. Epub 2016 Jan 21.
- Çıtak Karakaya İ, Yüksel İ, Akbayrak T, Demirtürk F, Karakaya MG, Ozyüncü Ö, Beksaç S. Effects of physiotherapy on pain and functional activities after cesarean delivery. Arch Gynecol Obstet. 2012 Mar;285(3):621-7. doi: 10.1007/s00404-011-2037-0. Epub 2011 Aug 10.
- Hanekom SD, Brooks D, Denehy L, Fagevik-Olsén M, Hardcastle TC, Manie S, Louw Q. Reaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidence. BMC Med Inform Decis Mak. 2012 Feb 6;12:5. doi: 10.1186/1472-6947-12-5.
- Mackay MR, Ellis E, Johnston C. Randomised clinical trial of physiotherapy after open abdominal surgery in high risk patients. Aust J Physiother. 2005;51(3):151-9.
- Reeve JC, Boden I. The physiotherapy management of patients undergoing abdominal surgery. New Zealand Journal of Physiotherapy. 2016;44(1).
- REC/00834 Zarfasheen Zia