Development of an In-bed Exercise Program to Prevent Postoperative Complications that can be Performed Immediately after Surgery: Experimental Study of Healthy Elderly Participants

Abstract

Background:Continuous postoperative bed rest causes decreased peripheral perfusion stasis of venous blood flow in the lower extremities and, decreased intestinal peristalsis and muscle mass. We aimed to develop an exercise program that could be carried out immediately after surgery and verified its usefulness in a preliminary study targeting healthy elderly individuals. Methods: Healthy elderly individuals were included in this prospective study. This comparative study was conducted from November 2021 to March 2022. The program consisted of grip movement of the fingers, active movement of the lower limbs, and lower limb trunk exercises. The participants were in a supine position on the bed, exercised for about 10 minutes based on the devised program, and the perfusion index and vital signs such as SpO2, blood pressure, and pulse rate were measured for 1 h every 5 minutes. Dyspnea and feeling tired were evaluated before, immediately after, and 10 min after the exercises using unmarked new 100 visual analog scale (VAS) sheets. Results: Both the upper and lower limbs showed significant improvement in peripheral perfusion immediately after exercise and lasted for 5–10 min. The pulse rate was significantly elevated for 5 min after finishing the exercises, but blood pressure and SpO2 remained unchanged. The VAS score of feeling tired was significantly higher immediately after exercise than before exercise, and no difference was observed before and 10 min after exercise, and the VAS scores for dyspnea did not differ between the three points. Conclusion: The exercise program devised in this study was expected to improve peripheral perfusion without straining the participants in this study, targeting healthy elderly individuals. This verification provided valuable data and proved that it could be developed into an intervention study for patients undergoing surgery.