Physiotherapy for UGI patients - Cat McLoughlin & Laura Maddison

The role of Physiotherapy in
the Nottingham Upper GI
ERAS project
Cath McLoughlin
Laura Maddison

The Physio role
• Early mobilisation is key –
lots of evidence to support
this
• Daily individual assessment
of suitability to exercise and
exercise progression
• Daily respiratory assessment
and treatment – early
identification of
complications.

Physio input
• Pre-op assessment
• Seen 1 st post op in am
• Progression of daily goals
• Promotion of independence
• Giving patient ownership of their recovery

Mobility Milestones
This is the minimum the patient should aim to do daily…
• Day 1 Sit out
• Day 2 Walk 10m
• Day 3 Walk 20m x2
• Day 4 Walk 30m x2
• Day 5 Length of ward x2
• Day 6 independent on ward, stair assessment if required
• Day 7 Discharge advice
• All combined with regular incentive spirometery and chest
clearance exercises – which the patient is encouraged to do
independently.

Audit
• N = 38
• Gender- 7 female ,31 male
• Age range- 48-85 years
• 55% return to ward day 1
• 50% fully completed daily milestones by day 6
• LoS- range 39 – 6
• 29% home in 7 days or less
• 68% home in 12 days or less

What Makes ERAS work…
• Strong leadership
• Good MDT working is essential
• Applying enhanced recovery to all patients – no exclusion criteria
• A clear, achievable pathway to give confidence to staff
• Ensuring patients are partners in their care
Vision for the future…
• Exercise class pre-operatively to optimise patients.
• Rehab post discharge
• True 7 day physio service
• Exercise circuits on the ward to encourage independence – exercise
diaries.

Questions and contacts
catherine.mcloughlin@nuh.nhs.uk
laura.maddison@nuh.nhs.uk