Effectiveness of Early Physiotherapy-Led Mobilization on Length of Hospital Stay in Post-Abdominal Surgery Patients

Abstract

BACKGROUND: Prolonged immobilization after abdominal surgery is associated with delayed recovery, increased postoperative complications, and extended hospital stay. Early mobilization has emerged as a key element of enhanced recovery protocols; however, locally generated interventional evidence supporting physiotherapy-led early mobilization remains limited in Pakistan.

OBJECTIVE: To evaluate the effectiveness of early physiotherapy-led mobilization on length of hospital stay and functional recovery in patients undergoing abdominal surgery.

METHODOLOGY: A randomized controlled trial was conducted in tertiary care hospitals in Punjab, Pakistan, over eight months. A total of 120 adult patients undergoing abdominal surgery were randomly allocated to either an early physiotherapy-led mobilization group or a standard postoperative care group. The intervention group received structured mobilization initiated within 24 hours after surgery, while the control group received routine care. The primary outcome was length of hospital stay. Secondary outcomes included time to first ambulation, functional status assessed using the Modified Barthel Index, postoperative pulmonary complications, and pain intensity. Data were analyzed using independent sample t-tests and chi-square tests, with statistical significance set at p < 0.05.

RESULTS: Patients in the early mobilization group demonstrated a significantly shorter mean hospital stay (4.1 ± 1.2 days) compared to the standard care group (6.0 ± 1.6 days; p < 0.001). Time to first ambulation was earlier in the intervention group (1.3 ± 0.4 days vs. 2.6 ± 0.7 days; p < 0.001). Functional independence at discharge was higher in the intervention group, with significantly greater Modified Barthel Index scores (p < 0.001). The incidence of postoperative pulmonary complications was lower in the early mobilization group, while pain levels at discharge were comparable between groups.

CONCLUSION: Early physiotherapy-led mobilization significantly improved postoperative recovery by reducing hospital stay and enhancing functional outcomes following abdominal surgery. Integrating structured physiotherapy into routine postoperative care may support enhanced recovery and efficient healthcare delivery in resource-limited settings.

KEY TERMS: Abdominal Surgery; Early Mobilization; Hospital Stay; Physiotherapy; Postoperative Care; Rehabilitation; Randomized Controlled Trial