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What Is the Evidence for Early Mobilisation in Elective Spine Surgery? A Narrative Review.

Burgess, L. and Wainwright, T., 2019. What Is the Evidence for Early Mobilisation in Elective Spine Surgery? A Narrative Review. Healthcare, 7 (3), 92.

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Burgess LC, Wainwright TW. What is the evidence for earth mobilisation in elective spine surgery A Narrative Review.pdf - Published Version
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DOI: 10.3390/healthcare7030092

Abstract

Early mobilisation is a cornerstone of Enhanced Recovery after Surgery (ERAS) and is encouraged following spinal procedures. However, evidence of its implementation is limited and there are no formal guidelines on optimal prescription. This narrative review aimed to evaluate the evidence for the effect of early mobilisation following elective spinal surgery on length of stay, postoperative complications, performance-based function and patient-reported outcomes. Four trials (five articles) that compared a specific protocol of early in-hospital mobilisation to no structured mobilisation or bed rest were selected for inclusion. Nine studies that investigated the implementation of a multimodal intervention that was inclusive of an early mobilisation protocol were also included. Results suggest that goal-directed early mobilisation, delivered using an evidence-based algorithm with a clear, procedure-specific inclusion and exclusion criteria, may reduce length of stay and complication rate. In addition, there is evidence to suggest improved performance-based and patient-reported outcomes when compared to bed rest following elective spinal surgery. Whilst this review reveals a lack of evidence to determine the exact details of which early mobilisation protocols are most effective, mobilisation on the day of surgery and ambulation from the first postoperative day is possible and should be the goal. Future work should aim to establish consensus-based, best practice guidelines on the optimal type and timing of mobilisation, and how this should be modified for different spinal procedures.

Item Type:Article
ISSN:1062-0257
Uncontrolled Keywords:spine surgery; early mobilisation; enhanced recovery after surgery (ERAS); physiotherapy; rehabilitation
Group:Faculty of Health & Social Sciences
ID Code:32557
Deposited By: Unnamed user with email symplectic@symplectic
Deposited On:22 Jul 2019 15:09
Last Modified:22 Jul 2019 15:09

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