Association of Early Ambulation and Duration of Hospital Stay in Neurological Indoor Patients
Early Ambulation in Neurological Patients
Keywords:ambulation, hospital stay, neurology, indoor patients
Background: Ambulation is important after surgery to make the patient walk freely. A patient may probably need help before being able to walk freely and reach their ambulation objective. It is critical to get the patient moving as soon as possible after surgery. Objective: To find out the association between early ambulation and duration of hospital stay in neurological indoor patients. Methods: Data was collected from 191 stroke patients aged between 30 to 60 years, both genders. It was a cross-sectional survey in which data was collected from the University of Lahore teaching hospital and the Ganga Ram hospital in Lahore. Pulse, temperature and body mass index were measured. Patients with severe cognitive impairment and cardiovascular disease were excluded from the study. Non-probability convenient sampling was used to collect the data. The data were analyzed by using the statistical package for the social sciences (SPSS) version 25.0 to provide descriptive statistics. For categorical variables, percentages and frequencies were calculated. For quantitative variables, means and standard deviations were estimated. Results: The results regarding the length of stay day showed that the mean and standard deviation were found to be 22.54±1.679 while the curve was normally distributed. The results regarding pre-hospital activity level showed that there were 19.4% of patients were in the general ward, 56.0% were indoors, 16.2% were outdoor, 4.2% were on steps and stairs and 4.2% fell. The results regarding the reason for hospitalization showed that 30.9% of patients were due to high blood pressure, 23.6% were due to ischemic, 20.4% were due to transient ischemic attack and 25.1% were due to pain. Conclusion: The findings of the study concluded that early ambulation has a direct impact on the early discharge of patients from the hospital. Moreover, the more distance patients were being ambulated, the speedier and better outcomes were coming in terms of patient’s stamina, respiratory rate, heart rate and early discharge.
Poletto SR, Rebello LC, Valença MJM, et al. Early mobilization in ischemic stroke: a pilot randomized trial of safety and feasibility in a public hospital in Brazil. Cerebrovascular diseases extra 2015; 5(1): 31-40.
Sahlstrand T. The Richards compression and sliding hip screw system in the treatment of intertrochanteric fractures. Acta Orthopaedica Scandinavica 1974; 45(1-4): 213-9.
Carli F, Mayo N, Klubien K, Schricker T, Trudel J, Belliveau P. Epidural analgesia enhances functional exercise capacity and health-related quality of life after colonic surgery: results of a randomized trial. The Journal of the American Society of Anesthesiologists 2002; 97(3): 540-9.
Fields LB. Oral care intervention to reduce incidence of ventilator-associated pneumonia in the neurologic intensive care unit. Journal of Neuroscience Nursing 2008; 40(5): 291-8.
Saidi K, Ben-Lulu O, Tsuji M, Safir O, Gross AE, Backstein D. Supracondylar periprosthetic fractures of the knee in the elderly patients: a comparison of treatment using allograft-implant composites, standard revision components, distal femoral replacement prosthesis. The Journal of arthroplasty 2014; 29(1): 110-4.
Schujmann DS, Teixeira Gomes T, Lunardi AC, et al. Impact of a progressive mobility program on the functional status, respiratory, and muscular systems of ICU patients: a randomized and controlled trial. Critical care medicine 2020; 48(4): 491-7.
Indredavik B, Bakke F, Slørdahl S, Rokseth R, Haheim L. Treatment in a combined acute and rehabilitation stroke unit: which aspects are most important? Stroke 1999; 30(5): 917-23.
Louw A, Nijs J, Puentedura EJ. A clinical perspective on a pain neuroscience education approach to manual therapy. Journal of Manual & Manipulative Therapy 2017; 25(3): 160-8.
Svendsen ML, Ehlers LH, Andersen G, Johnsen SP. Quality of care and length of hospital stay among patients with stroke. Medical care 2009: 575-82.
Yen H-C, Jeng J-S, Chen W-S, et al. Early mobilization of mild-moderate intracerebral hemorrhage patients in a stroke center: a randomized controlled trial. Neurorehabilitation and Neural Repair 2020; 34(1): 72-81.
Wang MY, Chang P-Y, Grossman J. Development of an Enhanced Recovery After Surgery (ERAS) approach for lumbar spinal fusion. Journal of Neurosurgery: Spine 2017; 26(4): 411-8.
Kenny G. The healers journey: A literature review. Complementary Therapies in Clinical Practice 2012; 18(1): 31-6.
Burt RK, Balabanov R, Han X, et al. Association of nonmyeloablative hematopoietic stem cell transplantation with neurological disability in patients with relapsing-remitting multiple sclerosis. Jama 2015; 313(3): 275-84.
Fürstenberg C, Wiedenhöfer B, Gerner H, Putz C. The effect of early surgical treatment on recovery in patients with metastatic compression of the spinal cord. The Journal of bone and joint surgery British volume 2009; 91(2): 240-4.
Paolucci S, Antonucci G, Grasso MG, Pizzamiglio L. The role of unilateral spatial neglect in rehabilitation of right brain–damaged ischemic stroke patients: a matched comparison. Archives of physical medicine and rehabilitation 2001; 82(6): 743-9.
Paolucci S, Bragoni M, Coiro P, et al. Quantification of the probability of reaching mobility independence at discharge from a rehabilitation hospital in nonwalking early ischemic stroke patients: a multivariate study. Cerebrovascular Diseases 2008; 26(1): 16-22.
Paolucci S, Grasso MG, Antonucci G, et al. Mobility status after inpatient stroke rehabilitation: 1-year follow-up and prognostic factors. Archives of Physical Medicine and Rehabilitation 2001; 82(1): 2-8.
Gosman-Hedström G, Claesson L, Klingenstierna U, et al. Effects of acupuncture treatment on daily life activities and quality of life: a controlled, prospective, and randomized study of acute stroke patients. Stroke 1998; 29(10): 2100-8.
Karlsson Å, Berggren M, Gustafson Y, Olofsson B, Lindelöf N, Stenvall M. Effects of geriatric interdisciplinary home rehabilitation on walking ability and length of hospital stay after hip fracture: a randomized controlled trial. Journal of the American Medical Directors Association 2016; 17(5): 464. e9-. e15.
Cumming TB, Thrift AG, Collier JM, et al. Very early mobilization after stroke fast-tracks return to walking: further results from the phase II AVERT randomized controlled trial. Stroke 2011; 42(1): 153-8.
De Almeida E, De Almeida J, Landoni G, et al. Early mobilization programme improves functional capacity after major abdominal cancer surgery: a randomized controlled trial. BJA: British Journal of Anaesthesia 2017; 119(5): 900-7.
Tuttle J, Shakir A, Choudhri HF. Paramedian approach for transforaminal lumbar interbody fusion with unilateral pedicle screw fixation: technical note and preliminary report on 47 cases. Neurosurgical focus 2006; 20(3): 1-5.
Jordbru AA, Smedstad LM, Klungsøyr O, Martinsen EW. Psychogenic gait disorder: a randomized controlled trial of physical rehabilitation with one-year follow-up. J Rehabil Med 2014; 46(2): 181-7.
Lee KB, Lim SH, Kim KH, et al. Six-month functional recovery of stroke patients: a multi-time-point study. International journal of rehabilitation research Internationale Zeitschrift fur Rehabilitationsforschung Revue internationale de recherches de readaptation 2015; 38(2): 173.
Needham DM, Korupolu R. Rehabilitation quality improvement in an intensive care unit setting: implementation of a quality improvement model. Topics in stroke rehabilitation 2010; 17(4): 271-81.
Bhat A, Chakravarthy K, Rao BK. Mobilization of patients in neurological Intensive Care Units of India: A survey. Indian Journal of Critical Care Medicine: Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine 2016; 20(6): 337.
How to Cite
Copyright (c) 2022 The Healer Journal of Physiotherapy and Rehabilitation Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.