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What Is the Evidence for Early Mobilisation in Elective Spine Surgery? A Narrative Review

1
Orthopaedic Research Institute, Bournemouth University, Bournemouth BH8 8EB, UK
2
Physiotherapy Department, The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth BH7 7DW, UK
*
Author to whom correspondence should be addressed.
Healthcare 2019, 7(3), 92; https://doi.org/10.3390/healthcare7030092
Received: 17 June 2019 / Revised: 12 July 2019 / Accepted: 14 July 2019 / Published: 18 July 2019
Early mobilisation is a cornerstone of Enhanced Recovery after Surgery (ERAS) and is encouraged following spinal procedures. However, evidence of its implementation is limited and there are no formal guidelines on optimal prescription. This narrative review aimed to evaluate the evidence for the effect of early mobilisation following elective spinal surgery on length of stay, postoperative complications, performance-based function and patient-reported outcomes. Four trials (five articles) that compared a specific protocol of early in-hospital mobilisation to no structured mobilisation or bed rest were selected for inclusion. Nine studies that investigated the implementation of a multimodal intervention that was inclusive of an early mobilisation protocol were also included. Results suggest that goal-directed early mobilisation, delivered using an evidence-based algorithm with a clear, procedure-specific inclusion and exclusion criteria, may reduce length of stay and complication rate. In addition, there is evidence to suggest improved performance-based and patient-reported outcomes when compared to bed rest following elective spinal surgery. Whilst this review reveals a lack of evidence to determine the exact details of which early mobilisation protocols are most effective, mobilisation on the day of surgery and ambulation from the first postoperative day is possible and should be the goal. Future work should aim to establish consensus-based, best practice guidelines on the optimal type and timing of mobilisation, and how this should be modified for different spinal procedures. View Full-Text
Keywords: spine surgery; early mobilisation; enhanced recovery after surgery (ERAS); physiotherapy; rehabilitation spine surgery; early mobilisation; enhanced recovery after surgery (ERAS); physiotherapy; rehabilitation
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Burgess, L.C.; Wainwright, T.W. What Is the Evidence for Early Mobilisation in Elective Spine Surgery? A Narrative Review. Healthcare 2019, 7, 92.

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