Assistive Intervention in the Characterization of Muscle Activity During Bed Rising and Assessment of Self-Perceived Recovery Measures for Abdominal Surgery Patients in Postoperative Care

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Date
2004-06-03
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Publisher
Virginia Tech
Abstract

Previous literature has indicated that nursing personnel face the second highest rate of occupational injury and illness. Assistive equipment, such as lift and transfer aids, has helped lower work task demands and reduce back stress on patient handlers. However, limited attention has been paid to the safety, comfort and dignity of the patient in postoperative care. Research on the efficacy of self-transfer aids for patients who require limited or no assistance by nursing personnel is insufficient. Ratings of comfort and security have only been evaluated for nursing home residents in a pilot field study, in which residents rated assistive devices as generally equal to or more secure and comfortable than manual transfer methods.

The first study reports the laboratory evaluation of bed rising with the use of two self-transfer aids and bed rising unassisted. The objective was to determine muscle activity during bed rising tasks with and without the use of a bed assistive device using surface electromyography (EMG). Twenty male (n = 9; age, 33.7 ± 8.0 years) and female (n = 11; age, 34.5 ± 23.9 years) participants, with normal body mass index (BMI) ranging from 18.4 to 24.9, took part in the study. Mean and peak activity was recorded from three abdominal muscle sites. The results indicated bed rising with the use of a self-transfer device significantly reduced muscle activity compared to bed rising unassisted. Anchoring the devices at a higher height and elevating the torso further reduced muscle activity. Although no differences were observed between devices using EMG, results from the usability survey and final ranking indicated favorable ratings for the ABNOSTRAINTM prototype compared to the Bed Pull-up.

A second study was conducted to determine the efficacy of a bed assistive device in a patient population. The objective was to compare self-perceived recovery measures and usage of pain medication between patients in the control (n = 8; age, 34.0 ± 6.3years) and device (n = 7; 40.7 ± 12.4) groups. A total of fifteen female participants undergoing either abdominal hysterectomy (n = 6) or Cesarean-section (n = 9) procedures were recruited for the study. Both groups completed a total of twelve questionnaires over a five-week recovery period. Responses to self-perceived recovery measures were significantly different. In general, the device group reported higher levels of energy, less pain interference, lower perceived pain, less reliance on pain medication and returned to activities of daily living faster than the control group.

The results from the study provide clinicians or other practitioners information on the benefits of bed assistive devices for patients during postoperative recovery. Age and surgery differences should be considered when suggesting bed movement patterns with assistive intervention.

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Keywords
postoperative care, clinical, pain medication, self-patient handling, assistive device, self-transfer aids, bed rising, electromyography, abdominal surgery
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