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Table 2 ICEAGE ambulation protocol

From: ICEAGE (Incidence of Complications following Emergency Abdominal surgery: Get Exercising): study protocol of a pragmatic, multicentre, randomised controlled trial testing physiotherapy for the prevention of complications and improved physical recovery after emergency abdominal surgery

Stage 1 (safety)

Sit over edge of bed/sit in chair minimum of 2 min

Stage 2 (safety)

March on spot 0–1 min

Stage 3 (ambulation)

March on spot/walk away from bedside 1–3 min

Stage 4 (ambulation)

March on spot/walk away from bedside 3–6 min

Stage 5 (ambulation)

Walk away from bedside 6–10 min

Stage 6 (ambulation)

Walk away from bedside 10–15 min

Stage 7 (ambulation)

Walk away from bedside > 15 min

Provide assisted early ambulation as soon as possible on the first postoperative day.

At each session, progress through each stage in sequence. Time achieved in the session is accumulative.

Aim to achieve rating of perceived exertion of greater than 3/10.

Aim to assist patient to ambulate more than 10 min (stage 6 or greater).

Once patient is able to ambulate past stage 3, patient can be assisted to ambulate with a physiotherapy assistant, as long as safe to do as determined by the ward physiotherapist.

Interval training is permissible to obtain target walking time. Each interval of rest time must not exceed the preceding work time. Total session time is the accumulative work time.

Provide assisted early ambulation once a day until discharged according to the discharge scoring tool.