Effect of Using Walking Aid on Mobility
Condition: Coronary Artery Bypass Graft Surgery; Pain; Early Mobilization; Walking, Difficulty
MeSH terms: Mobility Limitation
Study type: Interventional

Summary: 
      The goal of this clinical trial is to evaluate the effect of using walking aid during
      out-of-bed mobilization of patients who underwent open coronary artery bypass graft surgery
      on levels of pain and mobility. The main hypotheses are:

        1. The pain level of patients using walking aid is lower than that of those who do not.

        2. The mobility level of patients using walking aid is higher than that of those who do
           not.

      Participants will be asked to walk with using a walking aid during the first three
      mobilizations in the intensive care unit on the first postoperative day.
    

Detailed description: 
      Group allocation of the patients was done through using Random Allocation Software program
      and patients were allocated into two groups: the intervention group and the control group.

      Patients in the intervention group were asked to o walk with using a walking aid during the
      first three mobilizations in the intensive care unit on the first postoperative day.

      The researcher visited the patients in the CICU on the first day after surgery informed them
      that they were going to be mobilized out of the bed and walk in the room for two rounds
      (approximately 24 meters) for three times following each 4 hours by using a walking aid. The
      patients in the control group were informed that they were to be mobilized out of the bed and
      walk in the room for two rounds (approximately 24 meters) for three times following each 4
      hours with the help of two nurses.

      In the intervention group, to perform the first out-of-bed mobilization, the researcher and
      one other nurse supported helped the patient to straightening up in bed and then to sit in
      the bed. Then, the patient sat on the edge of the bed with their feet dangling outside.
      Following, with the brakes closed on the walking aid, the patient stood up from the bed and
      walked two rounds in the CICU room. The patient was then helped back to sit on the edge of
      the bed, and was asked to mark the level of pain and difficulty experienced during each
      activity on a horizontal line in the patient mobility scale.

      The Patient Mobility Scale scale was developed to measure the pain and difficulty levels
      experienced by patients during four activities (turning from one side to the
      other/straightening up in bed, sitting on the edge of the bed, standing up from the bed, and
      walking in the room) in the postoperative period. To evaluate pain, patients are asked to
      mark their level of pain for each activity on a line ranging from 0-"no pain" to 5-"worst
      pain imaginable." To evaluate difficulty, patients are asked to mark their perceived
      difficulty for each activity on a line ranging from 0-"very easy" to 5-"very difficult". The
      total score of the patient mobility scale is derived by summing the pain and difficulty
      scores for all activities, with the lowest possible score being 0 and the highest score being
      120. A lower score signifies that patients experienced less pain and difficulty during their
      activities, indicating a higher mobility level.

      In the control group, to perform the first out-of-bed mobilization, the researcher and one
      other nurse supported helped the patient to straightening up in bed and then to sit in the
      bed. Then, the patient sat on the edge of the bed with their feet dangling outside.
      Following, two nurses helped the patient stood up from the bed and walk two rounds in the
      CICU room. The patient was then helped back to sit on the edge of the bed and was asked to
      mark the level of pain and difficulty experienced during each activity on a horizontal line
      in the patient mobility scale.

      Four hours after the first and second mobilizations, both groups of patients underwent a new
      mobilization procedure, and the interventions applied during the first mobilization were
      repeated.
    

Intervention name(s): using a walking aid
Intervention type(s): Device
Intervention description(s): The walking aid utilized for mobilizing patients in the intervention group during the study is a four-wheeled device that allows for movement in all directions. The height of the device can be adjusted according to the patients' height. It features a seat for resting when needed and a braking system that is controlled from the hand grips.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Supportive Care