The Effect of Early Mobilization Techniques on Meliorating Fatigue and Physical Activity Tolerance of Patients Admitted to Cardiac Intensive Care Units

Mohadese Arab  Shahraby; Ladan  Sedighi; Neda  Sanaei; Malihe  Nasiri

doi:10.18502/aacc.v11i4.19363

Mohadese Arab Shahraby Department of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ladan Sedighi Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Neda Sanaei Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Malihe Nasiri Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v11i4.19363

Keywords: Cardiac surgery; Early mobilization; Fatigue; Physical activity; Post-operative; Coronary artery bypass grafting (CABG)

Abstract

Background: Patients undergoing Coronary Artery Bypass Grafting (CABG) frequently experience fatigue and physical activity tolerance as post-operative complications. The early mobilization technique is one of the beneficial nursing intervention programs that amend patients' outcomes, intercept immobilization, and increase quality of life. This study aimed to assess the effect of the early mobilization (EM) protocol on fatigue and physical activity tolerance in patients who underwent CABG.

Methods: We designed this study as a quasi-experiment with a control group. Participants involved patients who underwent CABG at the Intensive Care Unit (ICU) of Tehran Shahid Modarres Hospital in Iran between April and September 2023. The study included 96 patients, with 48 patients each in the intervention and control groups. Two distinct time points were used to select intervention and control groups (the initial three months and the following three months). Both the control and intervention groups received standard hospital care, but the intervention group also received an EM protocol education. We dedicated three days to intervention education and employment: day 0 (immediately after extubation), day 1 (24 hours later), and day 2 (48 hours later). We collected data were using the Visual Analog Scale-Fatigue (VAS-F) and the Borg scale at two time points (day 0 and day 2). We performed a paired t-test, an independent sample t-test, and an ANCOVA to analyse data.

Results: 56.3% of participants were men and 43.7% were women. The mean age of participants was 52.7±8.8. In both groups, hypertension (29.2%), hyperlipidemia (27.1%), and diabetes (20.8%) were the most prevalent CVD risk factors. The intervention group's mean fatigue decreased significantly on day 2 (4.40±0.94) compared to day 0 (6.65±1.12) while the mean PA tolerance increased significantly on day 2 (11.82±1.90) compared to day 0 (7.31%±1.20) (P<0.001). The control group did not experience any statistically significant intragroup changes (P>0.05). Significant intergroup changes were observed in the mean fatigue and PA tolerance values on day 2 (P<0.001) while there were no statistically significant intergroup changes in them on day 0 (P>0.05).

Conclusion: This study highlighted that early mobilization was an effective and safe inhibition program to meliorate fatigue and physical activity tolerance in CAD patients.