Early mobilisation after abdominal surgery: a concept analysis

Clinical Snapshot

Key Findings

• P Value: Not applicable - concept analysis

• Effect Size: Not applicable - concept analysis methodology

• Primary Outcome: Standardised definition of early mobilisation as active physical movement within 24 hours post-surgery

• Nnt Or Sensitivity: Key attributes: initiation within 24 hours, active movement (standing/sitting/walking), haemodynamic stability prerequisite

• Confidence Interval: Not applicable - qualitative synthesis

Clinical Application

High feasibility with standardised definition enabling consistent implementation and staff training Highly relevant to Australian perioperative care protocols, ANZCA guidelines, and Enhanced Recovery After Surgery (ERAS) programs implemented across Australian hospitals Adult patients undergoing abdominal surgery across all healthcare settings

Abstract

OBJECTIVE: To clarify and define the clinical practice concept of early mobilisation after abdominal surgery. DESIGN: A concept analysis guided by Walker and Avant's method. DATA SOURCES: MEDLINE (Ovid), AMED-(Ovid), Embase (Elsevier) and CINAHL (EBSCO) were searched through 5 December 2024. ELIGIBILITY CRITERIA: Relevant studies that included combinations of the terms 'early mobilisation', 'early ambulation', 'early acceleration', 'abdominal surgery' and 'surgical procedures' were selected. We restricted the search to English full-text publications involving adult patients, limited to the year 2000 and onward. Inclusion criteria were original research articles describing the timing and/or type of mobilisation. DATA EXTRACTION AND SYNTHESIS: The study derives its defining attributes, antecedents and consequences through data analysis. To enhance understanding of the model, we constructed related and contrary cases of the concept and outlined relevant empirical referents. RESULTS: In total, 140 studies were included in the analysis. Early mobilisation is characterised by the key defining attributes of initiating active physical movement, including standing, sitting in a chair or walking, within the first 24 hours of surgery. Antecedents include haemodynamic and respiratory stability, adequate pain management, and the patient's cognitive and physical readiness. Contextual antecedents include competent and adequately staffed healthcare teams. Consequences include improved physiological recovery and enhanced postoperative outcomes. CONCLUSIONS: This analysis provides a clarified, practice-focused definition of early mobilisation after abdominal surgery. By delineating its key attributes and contextual prerequisites, the study offers a conceptual foundation that can support clinical guidelines, promote consistent implementation and inform future research aimed at optimising postoperative recovery.

References

1. 1.Schandl, A., Siesage, K., Kroksmark, A. K., Gruber-De Sousa, E., Lilliecrona, J., & Olsén, M. F. (2026). Early mobilisation after abdominal surgery: a concept analysis. BMJ Open, 16(4), e107830. https://doi.org/10.1136/bmjopen-2025-107830