The Effectiveness of Early Mobilisation on Physical Function in Patients After Heart Valve Surgery

Abstract

Background/Aims Literature suggests that early mobilisation (EM), defined as the initiation of physical activity within 48 hours following surgery, improves outcomes after cardiac surgery. This systematic review assessed the effectiveness of EM on physical function and other outcomes such as length of hospital stay and cost following heart valve surgery.

Methods The Physiotherapy Evidence Database (PEDro), MEDLINE, EMBASE, CINAHL, and Cochrane Library were systematically searched from inception until May 2022 using relevant keywords. Included were randomised controlled trials (RCTs) comparing EM versus usual care in adult heart valve surgery patients. Methodological quality was assessed using the PEDro scale and risk of bias using the Cochrane Risk of Bias Tool 2 (RoB2). The data were narratively synthesised.

Results Three RCTs with 161 patients were included. EM protocols varied across trials. Two trials (n=124) reported significantly greater improvement in physical function with EM versus usual care, including handgrip strength (p=0.001). One study (n=41) found EM significantly reduced the length of hospital stay (p=0.000), in-hospital care costs (p=0.000), and intensive care unit (ICU) stay (p=0.000) compared to usual care. Methodological quality scores ranged from five to eight on the PEDro scale. The risk of biased judgement was ‘low’ in one study and ‘some concerns’ in two studies.

Conclusions EM may improve physical function and reduce hospital and ICU stays after heart valve surgery. However, differences in protocols and limited studies indicate further high-quality research is needed, particularly on cost-effectiveness. Establishing clear EM protocols could enhance recovery in this population.