Efeitos da mobilização em menos de 24 horas baseada na ICU mobility scale em pacientes com neoplasias abdominais submetidos a cirurgias de grande porte: ensaio clínico controlado e randomizado

Abstract

Introduction: Major abdominal cancer surgery is an example of surgical trauma that leads to a substantial loss of functional capacity. Objective: To evaluate the effects of mobilization in less than 24 hours applied in patients with abdominal neoplasms undergoing major surgeries. Materials and methods: controlled and randomized clinical trial, carried out from December 2021 to August 2022 at the Intensive Care Unit of the Cancer Hospital of Maranhão. Patients in the intervention group performed mobility activities guided by the IMS scale in the first 24 hours after surgery and the control group performed conventional physiotherapy. Dynamometry was evaluated preoperatively, on the 1st POD and postoperatively, and the TUG on hospital admission and discharge. Results: The study sample consisted of 28 patients, 13 from the control group and 15 from the intervention group. There was a slight predominance of males (48.4%), with a mean age of 56.7 ± 14.0 years. The most frequent diagnosis was gastric adenocarcinoma in both groups (42.9%), consequently the most common surgery was gastrectomy (42.9%). Patients in the intervention group had their first visit less than 24 hours after admission to the ICU (intervention group: 20.07 ± 0.81; control group: 34.31 ± 3.69; p: 0.00) and presented greater initial mobility compared to the control group (Intervention group IMS scale: 6.67 ± 0.69; Control group IMS scale: 2.23 ± 0.52; p: 0.001). There was a greater progression in the level of mobility until discharge from the ICU in patients in the intervention group compared to those in the control group (IMS at discharge from the ICU intervention group: 8.53 ± 0.33; IMS at discharge from the ICU control group: 3 ± 0.64). There was no significant difference in handgrip strength at all times. Both groups showed an increase in the time to perform the TUG test, but this increase was significant only in the control group. Conclusion: Early mobilization in less than 24 hours in patients with abdominal cancer undergoing major surgery proved to be effective in maintaining mobility and functional markers in the intervention group when compared to the control group.