The Role of Early Mobilisation in Physiotherapy Rehabilitation Following Abdominal Surgery
By Augustin C. Webber , Physiotherapist
Abdominal surgery refers to a wide range of surgical procedures performed on organs within the abdominal cavity. This includes the stomach, intestines, liver, pancreas, spleen, and more. These procedures may be elective or emergency-based and are typically carried out to treat conditions such as appendicitis, hernias, gastrointestinal cancers, bowel obstructions, or inflammatory diseases such as Crohn’s disease or ulcerative colitis (Brunicardi et al., 2019).
To address these conditions and enhance recovery, multidisciplinary post-operative care—particularly physiotherapy—has become increasingly important.
According to Haines et al. (2013), physiotherapy plays a key role in improving outcomes, increasing patient satisfaction, and reducing hospital stays. Early mobilisation—such as sitting up in bed, standing, and walking within 24 to 48 hours after abdominal surgery—is especially significant. The aims of early mobilisation are as follows:
1. Reducing Post-operative Complications
One of the most important benefits of early mobilisation is the prevention of complications such as pulmonary infections, deep vein thrombosis (DVT), and muscle atrophy. Prolonged bed rest following abdominal surgery may lead to reduced lung expansion, which can result in atelectasis and pneumonia. Early movement improves lung function by promoting deeper breathing and more effective coughing, helping to clear secretions and maintain oxygenation (Hulzebos et al., 2006).
Additionally, physical activity improves blood circulation, which lowers the risk of DVT and pressure ulcers. Mobility also stimulates gastrointestinal function, reducing the risk of post-operative ileus, a common issue after abdominal procedures.
2. Enhancing Functional Recovery
Early mobilisation promotes a quicker return to daily activities. Encouraging patients to move soon after surgery helps maintain muscle strength, coordination, and balance. Functional tasks such as sitting, standing, and walking are gradually introduced based on the patient’s tolerance, thereby reducing the time required to regain independence.
3. Supporting Psychological Well-being
Recovery from surgery is not only physical but also psychological. Prolonged immobility can lead to feelings of anxiety and low self-esteem. Early mobilisation provides a sense of progress and control, which helps improve mental well-being and motivation. It also encourages patients to engage in their own recovery, increasing adherence to physiotherapy plans and fostering a more proactive mindset.
4. Implementation and Considerations
For early mobilisation to be effective, it must be carefully planned and individualised. The physiotherapist assesses the patient’s medical stability, type of surgery, and pain levels to determine a safe starting point. Interventions typically begin with bed-based exercises and progress to sitting, standing, and walking short to longer distances. Pain management, patient education, and interprofessional collaboration are essential for successful implementation.
Despite the clear benefits, barriers such as patient fear, fatigue, and limited staffing may delay recovery. Addressing these through education, reassurance, and proper planning is vital to ensure consistency and patient’s safety.
Conclusion
arly mobilisation plays a pivotal role in the physiotherapy rehabilitation of patients following abdominal surgery. It reduces the risk of complications, accelerates recovery, and improves both physical and psychological outcomes. When introduced early and tailored to individual needs, mobilisation becomes a powerful tool in enhancing recovery and restoring independence. Therefore, it should be a routine component of post-operative physiotherapy care for patients undergoing abdominal surgery.
References
Brunicardi, F. C., et al. (2019). Schwartz’s Principles of Surgery (11th ed.). McGraw-Hill.
Haines, K. J., Skinner, E. H., & Berney, S. (2013). Association of postoperative pulmonary complications with delayed mobilisation. Physiotherapy, 99(2), 119–125.
Hulzebos, E. H., et al. (2006). Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications. JAMA, 296(15), 1851–1857.
