The Importance of Early Mobility for Bariatric Patients

Early mobility is crucial for all patients during the rehabilitation process. But it is especially essential for bariatric patients to achieve early mobility as they recover from surgery or an injury. Aiming for meaningful mobilization as quickly as possible is pivotal to reducing complications and improving recovery.

What does achieving early mobility look like? It encompasses sitting upright, transferring, exercising, rising from a chair, and walking – all while progressing towards independent movement.

These activities are performed with the assistance of an occupational or physical therapist.

Early initiated activities are particularly vital in the realm of bariatric and metabolic surgery. This is because bariatric patients are at greater risk of developing postoperative complications that include cardiopulmonary complications and venous thromboembolism (VTE) compared to patients who have a BMI (Body Mass Index) of lower than 30. Early mobility has been shown to greatly lessen the likelihood of VTE in bariatric patients.

Bariatric patients, because of their larger sizes, are also susceptible to slips and falls during their stays at rehab hospitals. This leaves them at risk for more injuries or exacerbating their existing injuries. It is not uncommon for bariatric patients to settle into complacency and not be exercised enough. The extra weight of a bariatric patient can make it particularly challenging for physical therapists to manuever them during their exercise regimens. The use of assistive equipment has made it significantly easier for therapists to engage bariatric patients in early mobility exercises.

But as we will present in this article, it is especially necessary for bariatric patients to achieve early mobility so their physical conditions do not deteriorate during the rehab period. The goal among physical therapists is to have patients, and, in particular bariatric patients, out of bed as much as possible and exercising as they seek to improve their capacity for independent movements.

Early mobility is part of the Enhanced Recovery After Surgery (ERAS) protocol. It is actually a key element of ERAS and is crucial to improving outcomes for bariatric patients in rehab. 

What are Enhanced Recovery After Surgery (ERAS) Pathways?

Enhanced Recovery After Surgery (ERAS) protocols are multimodal, patient-centered pathways designed to optimize recovery by minimizing surgical stress and facilitating early recovery through evidence-based practices throughout the pre-, intra-, and post-operative periods. ERAS has been proven to reduce hospital stays and prevent postoperative complications.

ERAS protocols typically include specific targets for the amount of time out of bed and the distance walked.

Early postoperative mobilization is a pivotal element of postoperative recovery in ERAS.

Considerations and Best Practices for Early Mobility

Involve a Multi-Disciplinary Team

Early mobilization requires a multi-disciplinary team that includes physical therapists, nurses,
and doctors. They all provide customized support and personalized guidance.

Early Intervention 

The objective is to bring about meaningful mobilization as soon as possible following surgery – ideally within the first 24 hours.

Safe Patient Handling 

It is best to implement proper lifting and transferring techniques as they are essential to averting injury to both patients and staff.

Gradual Progression 

It is best to begin with basic activities such as transferring from bed to chair, sitting upright, and then progress to standing and walking.

Patient-Specific Goals

Early mobilization must be individualized and based on the patient’s condition and tolerance.

Bariatric Mobility Equipment 

Rehabilitation hospitals should have the necessary bariatric mobility equipment like step stools, specialty beds, and commodes to ensure patient safety and comfort during the mobilization process.

Addressing Barriers

Patient-reported factors such as discomfort, fatigue, and dizziness could lessen mobility. That is why addressing these concerns is critical.

Pre-operative Patient Education 

Communicating the importance of early mobilization can assist bariatric patients in understanding their role in their recovery. 

Key Aspects of Bringing About Mobility in Bariatric Patients 

Individualized Exercise Plans:  It is advisable to cater exercise routines to a patient’s unique needs and limitations that take into account their current fitness level and joint health.

Proper Body Mechanics Training:  It is important to educate patients on safe lifting techniques and how to move in ways that limit strain on their bodies.

Managing Discomfort:  It is helpful to address any discomfort issues associated with movement during therapy sessions. 

Benefits of Early Mobility for Bariatric Patients During Rehab

Early mobilization during rehab treatments for bariatric patients accelerates the recovery of functional walking capacity, positively affects several patient-reported outcomes, lessens medical complications, and decreases hospital length of stay. This all results in curtailing medical costs. 

Here are the many additional advantages of early mobility for bariatric patients during the rehab regimen. 

Decreases Postoperative Complications – Early mobilization can prevent complications like pressure ulcers, deep vein thrombosis, and pulmonary issues.

Strengthens Overall Recovery – By improving blood circulation and lessening the risk of complications, early mobilization supports quicker recovery and convalescence.

Improves Gastrointestinal Recovery – Early mobility exercises have been shown to assist in preventing or lessening gastrointestinal complications.

Improves Cardiovascular Function – Even minimal amounts of physical activity can improve cardiovascular health and decrease the chances of long-term complications.

Improves Wound Healing – Early movement during the rehab process will aid circulation and that is critical for optimal wound healing.

Improves Muscle Strength and Endurance – By participating in early mobility exercises, bariatric patients could see their muscles strengthened. This is especially helpful for larger-size patients who typically have underlying muscle weakness.

Improves Mental Health – Early mobility can also decrease stress and improve a patient’s well-being.

Leads to Faster Discharge – By improving a patient’s functional status and minimizing complications, early mobility contributes to a shorter hospital stay.

Prevents Skin Breakdown – Being mobile helps to prevent pressure ulcers, which can be a common medical condition for people with limited mobility. 

Barihab™ Therapy Equipment Promotes Early Mobility for Bariatric Patients 

The Barihab™’s range of products offers pioneering rehabilitation technology that integrates seamlessly into any therapeutic environment. Each piece of equipment provides multifunctional capabilities, ensuring safe, efficient, and effective treatment options for diverse patient needs, including the specific needs of larger-size patients.

For rehabilitation centers focused on efficiency, innovation, and measurable patient success, Barihab™ represents the next evolution in bariatric care. Your therapists will be able to leverage the best-in-market Barihab™ rehabilitation equipment to provide early mobility exercises designed to enable your patients to reclaim their independence and enhance their well-being. 

Early Mobility is Critical for Bariatric Patients During Rehab 

Early mobility could not be more important for larger-size patients given how susceptible they are to medical complications. For example, some procedures carry a mortality risk of up to 1 percent and a serious complication risk of as much as 10 percent. Complications can be short-term or long-term. They can include nutritional deficiencies, dumping syndrome, and others.

One study of 1,888 obese people who underwent bariatric surgery or specialized medical treatment with a median of 6.5 years of follow-up found that bariatric surgery was associated with higher complication rates, and that included gastrointestinal surgery.

It is for reasons like these that early mobilization is so critical for bariatric patients within a rehab treatment program. Larger-size patients who participate in early mobility exercises have a significantly lower likelihood of experiencing other medical complications such as blood clots, pressure ulcers, and pneumonia. They also enjoy the benefits of muscle strength, improved circulation, and superior overall outcomes by promoting blood flow and preventing muscle atrophy.

Early mobility enables bariatric patients to more quickly achieve independence and have shorter hospital stays. These advantages extend to improved psychological and physical states and enhanced well-being.