A Controlled Trial of the Efficacy of a Training Walking Program in Patients Recovering from Abdominal Aortic Aneurysm Surgery.

BACKGROUND: Major surgical procedures as well as general anesthesia contribute to muscle weakness and posture instability and may result in increased postoperative complications and functional disorders resulting from an elective operation.

OBJECTIVES: We aim to state the significance of backward walking as a form of interval march training with patients after abdominal aortic aneurysm surgery.

MATERIAL AND METHODS: Sixty-five patients were randomly divided into three subgroups and three various models of physiotherapy were applied. The participants were males, aged 65-75 years, with stable cardiologic status, absence of neurological disorders, and non-symptomatic aneurysm - non-ruptured, no pain complaints and no motor system impairments. The control group had only routine physiotherapy, since therapeutic groups I and II also had walking exercises, forward in group II and backward in group I. Both experimental groups were applied interval training. The patient data analyzed was as follows: hospitalization period-days; 6-min walking test-distance (m), training heart rate (1/min), mean speed (km/h), MET; spirometry test-FVC(L), FEV1(L), FEV1/FVC and PEF(L/s).

RESULTS: The hospital stay period in all groups did not vary significantly. Statistical analysis showed that patients with backward walking had a statistically significantly lower reduction of walking distance in the corridor test when compared to the control group (p < 0.05). After the operation, a significant reduction of mean speed in the control group was noted in comparison with both the forward and backward walking groups (p < 0.05). No significant differences were noted between the experimental groups in average walking speed as well as in heart rate in all observed groups.

CONCLUSIONS: Physical training applied to patients after major abdominal aortic aneurysm surgery influences sustaining the level of exercise tolerance to a small extent. Both backward and forward walking seem to be alternative methods when compared to classic post-surgery physiotherapy.