Impact of Early Mobility Programme on Open Abdominal Surgery Patients’ Post-Operative Bowel Function Recovery during the First 72 Hours


  • Sunisa Koesanthia Faculty of Nursing, Mahidol University
  • Kessiri Wongkongkam
  • Suporn Danaidutsadeekul
  • Thammasak Thawitsri


open abdominal surgery, early mobiliity, bowel function recovery, postoperative patients


Objective: To study the impact that an early mobility programme had on the post-operative bowel function recovery in open abdominal surgery patients during the frst 72 hours
Design: Quasi-experimental research
Methodology: The sample consisted of 50 major abdominal surgery patients treated at a tertiary hospital. Twenty-fve subjects were assigned into the control group, and the remainder into the experimental group. Whilst the control group received only standard nursing care, the experimental group participated in the early mobility programme, which was divided into 3 levels: 1) lying on the bed; 2) sitting; and 3) walking. Data collection tools comprised a demographic questionnaire, a disease and treatment record form, and a bowel function recovery assessment form. The data were analysed by using Chi-square test, Mann-Whitney U Test, Friedman Test, and Wilcoxon Signed Ranks Test. 
Results: The experimental group showed a signifcantly higher increase in their average score on postoperative bowel function recovery on day 2 and day 3 than did the patients who received only standard nursing care (p < .001).
Recommendations: The early mobility programme could improve postoperative bowel function. Therefore, it is recommended that application of his programme start from the preoperative period and be exercised twice daily, for 20-30 minutes per session, to stimulate the patient’s postoperative mobility. 


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Sattayawiwat W, Phataranavic P, Honghern P, Toskulkao T, Asdornwised U, Boonnuch W, et al. A study of symptom disturbances and complications in surgical patients. Journal of the Thai Orthopaedic Nurses’ Society. 2003;2: 108-123. (in Thai)

Chapuis PH, Bokey L, Keshava A, Rickard MJ, Stewart P, Young CJ, et al. Risk factors for prolonged ileus after resection of colorectal cancer: an observational study of 2400 consecutive patients. Ann Surg. 2013; 257(5):909-15.

Millan M, Biondo S, Fraccalvieri D, Frago R, Golda T, Kreisler E. Risk factors for prolonged postoperative ileus after colorectal cancer surgery. World J Surg. 2012;36(1):179-85.

Moghadamyeghaneh Z, Hwang GS, Hanna MH, Phelan M, Carmichael JC, Mills S, et al. Risk factors for prolonged ileus following colon surgery. Surg Endosc. 2016;30(2):603-9.

Vather R, Josephson R, Jaung R, Robertson J, Bissett I. Development of a risk stratifcation system for the occurrence of prolonged postoperative ileus after colorectal surgery: a prospective risk factor analysis. Surgery. 2015;157(4):764-73.

Vather R, Bissett IP. Risk factors for the development of prolonged post-operative ileus following elective colorectal surgery. Int J Colorectal. 2013;28(10): 1385-91.

Shah DR, Brown E, Russo JE, Li C-S, Martinez SR, Coates JM, et al. Negligible effect of perioperative epidural analgesia among patients undergoing elective gastric and pancreatic resections. J Gastrointest Surg. 2013;17(4):660-7.

Wolthuis A, Bislenghi G, Fieuws S, de Buck van Overstraeten A, Boeckxstaens G, D’Hoore A. Incidence of prolonged postoperative ileus after colorectal surgery: a systematic review and meta‐analysis. Colorectal Dis. 2016;18(1):O1-O9.

Research Unit of Surgery Pramongkutklao Hospital. Annual statistics. 2015.

Venara A, Neunlist M, Slim K, Barbieux J, Colas PA, Hamy A, et al. Postoperative ileus: pathophysiology, incidence, and prevention. J Visc Surg. 2016;153(6): 439-46.

Luckey A, Livingston E, Taché Y. Mechanisms and treatment of postoperative ileus. Arch Surg. 2003; 138(2):206-14.

Senagore AJ. Pathogenesis and clinical and economic consequences of postoperative ileus. Am J Health Syst Pharm. 2007;64:S3-S7.

Iyer S, Saunders WB, Stemkowski S. Economic burden of postoperative ileus associated with colectomy in the United States. J Manag Care Pharm. 2009; 15(6):485-94.

Holte K, Kehlet H. Postoperative ileus: a preventable event. Br J Surg. 2000;87(11):1480-93.

Kibler VA, Hayes RM, Johnson DE, Anderson LW, Just SL, Wells NL. Cultivating Quality: Early postoperative ambulation back to basics. Am J Nurs. 2012;112(4): 63-9.

Ahn K-Y, Hur H, Kim D-H, Min J, Jeong DH, Chu SH, et al. The effects of inpatient exercise therapy on the length of hospital stay in stages I–III colon cancer patients: randomized controlled trial. Int J Colorectal Dis. 2013;28(5):643-51.

Songkawat S, Pearkao P. Effects of the 72 hours postoperative nursing care programin urgent abdominal surgery on postoperative gut obstruction recovery. Udonthani Hospital Medical Journal. 2012; 20: 186-95. (in Thai)

Chaivat Toskulkao. Digestive physiology. 2nd ed. Bangkok: Text and Journal; 1999. (in Thai)

Trongsakul S, Lambert R, Clark A, Wongpakaran N, Cross J. Development of the Thai version of Mini-Cog, a brief cognitive screening test. Geriatr Gerontol Int. 2015; 15(5):594-600.

Borson S, Scanlan J, Brush M, Vitaliano P, Dokmak A. The mini‐cog: a cognitive ‘vital signs’ measure for dementia screening in multi‐lingual elderly. Int J Geriatr Psychiatry. 2000;15(11):1021-7.

Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O’Neal PV, Keane KA, et al. The richmond agitationsedation scale: validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002; 166(10):1338-44.

McCaffery M, Beebe A. Pain: clinical manual for nursing practice. Mosby Elsevier. 1989.

Devlin JW, Skrobik Y, Gélinas C, Needham DM, Slooter AJC, Pandharipande PP, et al. Clinical practice guidelines for the prevention and management of pain, agitation/Sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med. 2018;46(9):e825-e73.

Sommers J, Engelbert RH, Dettling-Ihnenfeldt D, Gosselink R, Spronk PE, Nollet F, et al. Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations. Clin Rehabil. 2015;29(11):1051-63.

Silva Y, Li S, Rickard M. Does the addition of deep breathing exercises to physiotherapy-directed early mobilisation alter patient outcomes following high-risk open upper abdominal surgery? cluster randomised controlled trial. Physiotherapy. 2013; 99(3):187-93.

Phamornpon S, Toskulkao T, Kimpee S, Iramaneerat C. Factor predicting bowel function recovery in patients after open colorectal resection surgery. Journal of Thai Association of Radiation Oncology. 2013; 1: 38-46. (in Thai)

Grass F, Slieker J, Jurt J, Kummer A, Solà J, Hahnloser D, et al. Postoperative ileus in an enhanced recovery pathway a retrospective cohort study. Int J Colorectal Dis. 2017;32(5):675-81.

Morisawa T, Takahashi T, Nishi S. Effects of passive lower limb and trunk exercises and diaphragm breathing exercise on intestinal movement. J Phys Ther Sci. 2013;25(1):117-9.



How to Cite

Koesanthia S, Wongkongkam K, Danaidutsadeekul S, Thawitsri T. Impact of Early Mobility Programme on Open Abdominal Surgery Patients’ Post-Operative Bowel Function Recovery during the First 72 Hours. TJNC [Internet]. 2022 May 12 [cited 2022 Dec. 9];37(02). Available from: