Nonpharmacological strategies include graduated compression stockings, intermittent pneumatic compression, leg elevation, and early mobilization.
No differences in fat mobilization from leg, arm and trunk regions were found, but lactating women had a non-significant 2 kg greater decline in total fat mass [ 35].
1, 25-Dihydroxyvitamin D (0.025 0.050 μg/kg per day) was stopped about a week before surgery and was readministered when mobilization of the leg became possible, usually 5too 7 days after the operation [ 2, 11].
All of the patients underwent a supervised and standardized rehabilitation program that included proper positioning, passive and active mobilization (that is, leg and arm exercises in bed or in a chair if possible), management of secretion, and (if feasible) ambulation using a walker with the aid of the ventilator and the assistance of a respiratory therapist.
However, in order to prevent hypovolaemia, patients underwent a liberal intra- and postoperative fluid protocol and we sought to identify hypovolaemia prior to mobilization by a passive leg raise test.
During hospital stay the sensor was applied to the thigh of the un-operated leg to preclude measurement errors due to intervention-related joint mobilization.
Third, passive mechanical loading had a significant and consistent positive effect on the force-generating capacity of individual muscle fibers in the loaded leg, strongly supporting the importance of early physical therapy and mobilization in deeply sedated and mechanically ventilated ICU patients.
The theory behind mobilization is that pain restricts the movement of the leg, but then the hip joint becomes stiff, and this leads to a further loss of movement, and a downward cycle of under-use established.
Mobilization included supine rest (5 min), followed by 30° passive leg raise (3 min), supine rest (5 min), sitting on the bed with the feet on the floor (3 min), followed by standing while the patient was verbally encouraged to stand on the toes and shift body weight from one leg to the other in order to activate the muscle pump and attenuate venous pooling in the legs (3 min) [ 14].
Full extension of hip and stifle joints during wrapping of the lower leg is crucial to avoid later shifting of the drapes during intraoperative joint mobilization.
