| Study . | Country . | Design . | Included patients (n) . | Field of surgery . | Technique* . | Intervention† (duration/assistance/type) . | Primary outcome (sec. outcomes) . |
|---|---|---|---|---|---|---|---|
| Ahn 2013 | Korea | RCT | 41 | Colon | o, l (77), r (6) | POD 1–dis/P/stretching and ambulation twice daily | LOS (time to flatus, morbidity rate, walking distance) |
| Fiore 2017, Balvardi 2021§ | Canada | RCT | 100 | Colorectal | o, l (81) | POD 0–dis/P/ambulation 3 times daily | 6MWT‡ (FVC, FEV1, PPC, step count, LOS, GI recovery, morbidity rate) |
| Bhatt 2017 | Ireland | Prosp. observ. | 60 | UGI, hepatobiliary, colorectal | o, l | POD 2–dis/P/pedal exerciser twice daily | PPC (dyspnoea score, LOS) |
| Boerrigter 2022 | Netherlands | Retro. observ. | 373 | UGI, HPB, colorectal | n.a. | POD 1–3/P/increased ambulation targets (max. 1125 m daily) | Ceiling effect of target goals (LOS) |
| de Almeida 2017 | Brazil | RCT | 108 | UGI, HPB, colorectal, urological (3–6%) | o, l (22) | POD 1–dis/P/physical exercises including walking/strengthening exercise/cycle ergometry twice daily | Inability to ambulate at POD 5 (6MWT, fatigue, QoL, morbidity rate, LOS) |
| Fagevik Olsén 2021 | Sweden | RCT | 83 | Pancreatic | o | POD 0–dis/P/ambulation and cycle ergometry (2–3 times daily) | Oxygenation (pulmonary function, pneumonia rate, LOS) |
| Grass 2018 | Switzerland | Retro. | 1170 | Colorectal | o, l (58) | POD 1–3/E/ambulation out of bed ≥6 h on POD 1 | Compliance to mobilization (morbidity rate, LOS) |
| Koyuncu 2021 | Turkey | Prosp. | 42 | UGI, pancreatic, colorectal | n.a. | POD 0/E/ambulation 2 h out of bed on POD 0 | Mobilization time (sleep quality, bowel function, LOS) |
| Ni 2018 | China | RCT | 120 | Hepatic | n.a. | POD 1–5/P/ambulation beginning POD 2, 2–5 times daily | Step count (pain, sleeping state, bowel function, morbidity rate, LOS) |
| Ni 2022 | China | RCT | 120 | Hepatic | n.a. | POD 1–5/P/ambulation beginning POD 2, 2–5 times daily | Sleep quality (pain, bowel function, step count, LOS) |
| Nishijima 2020 | Japan | Retro. | 718 | UGI (excl. oesophagus), HPB, colon | o, l (50) | POD 1–dis/P/ambulation >20 m (during POD 1–2 versus later) | Morbidity rate (LOS) |
| Rosowicz 2022 | USA | Retro. | 291 | Colorectal | o, l (76) | POD 0–dis/E/ambulation (within 24 h versus later begin) | Morbidity rate (LOS) |
| Van der Leeden 2016 | Netherlands | Retro. | 116 | UGI, hepatic, colorectal, other | o, l (24) | POD 0–5/P/ambulation target goals (scheduled distance) | PPC (LOS, 6MWT) |
| Wiklund 2015 | Sweden | RCT | 66 | Gastric bypass (bariatric) | l | POD 1–7/D, E/ambulation (target step count) | Step count (bowel function, LOS) |
| Wolk 2019 | Germany | RCT | 132 | UGI, HPB, colorectal | o, l (51) | POD 1–5/D, P/ambulation (target step count) | Step count (morbidity rate, LOS) |
| Study . | Country . | Design . | Included patients (n) . | Field of surgery . | Technique* . | Intervention† (duration/assistance/type) . | Primary outcome (sec. outcomes) . |
|---|---|---|---|---|---|---|---|
| Ahn 2013 | Korea | RCT | 41 | Colon | o, l (77), r (6) | POD 1–dis/P/stretching and ambulation twice daily | LOS (time to flatus, morbidity rate, walking distance) |
| Fiore 2017, Balvardi 2021§ | Canada | RCT | 100 | Colorectal | o, l (81) | POD 0–dis/P/ambulation 3 times daily | 6MWT‡ (FVC, FEV1, PPC, step count, LOS, GI recovery, morbidity rate) |
| Bhatt 2017 | Ireland | Prosp. observ. | 60 | UGI, hepatobiliary, colorectal | o, l | POD 2–dis/P/pedal exerciser twice daily | PPC (dyspnoea score, LOS) |
| Boerrigter 2022 | Netherlands | Retro. observ. | 373 | UGI, HPB, colorectal | n.a. | POD 1–3/P/increased ambulation targets (max. 1125 m daily) | Ceiling effect of target goals (LOS) |
| de Almeida 2017 | Brazil | RCT | 108 | UGI, HPB, colorectal, urological (3–6%) | o, l (22) | POD 1–dis/P/physical exercises including walking/strengthening exercise/cycle ergometry twice daily | Inability to ambulate at POD 5 (6MWT, fatigue, QoL, morbidity rate, LOS) |
| Fagevik Olsén 2021 | Sweden | RCT | 83 | Pancreatic | o | POD 0–dis/P/ambulation and cycle ergometry (2–3 times daily) | Oxygenation (pulmonary function, pneumonia rate, LOS) |
| Grass 2018 | Switzerland | Retro. | 1170 | Colorectal | o, l (58) | POD 1–3/E/ambulation out of bed ≥6 h on POD 1 | Compliance to mobilization (morbidity rate, LOS) |
| Koyuncu 2021 | Turkey | Prosp. | 42 | UGI, pancreatic, colorectal | n.a. | POD 0/E/ambulation 2 h out of bed on POD 0 | Mobilization time (sleep quality, bowel function, LOS) |
| Ni 2018 | China | RCT | 120 | Hepatic | n.a. | POD 1–5/P/ambulation beginning POD 2, 2–5 times daily | Step count (pain, sleeping state, bowel function, morbidity rate, LOS) |
| Ni 2022 | China | RCT | 120 | Hepatic | n.a. | POD 1–5/P/ambulation beginning POD 2, 2–5 times daily | Sleep quality (pain, bowel function, step count, LOS) |
| Nishijima 2020 | Japan | Retro. | 718 | UGI (excl. oesophagus), HPB, colon | o, l (50) | POD 1–dis/P/ambulation >20 m (during POD 1–2 versus later) | Morbidity rate (LOS) |
| Rosowicz 2022 | USA | Retro. | 291 | Colorectal | o, l (76) | POD 0–dis/E/ambulation (within 24 h versus later begin) | Morbidity rate (LOS) |
| Van der Leeden 2016 | Netherlands | Retro. | 116 | UGI, hepatic, colorectal, other | o, l (24) | POD 0–5/P/ambulation target goals (scheduled distance) | PPC (LOS, 6MWT) |
| Wiklund 2015 | Sweden | RCT | 66 | Gastric bypass (bariatric) | l | POD 1–7/D, E/ambulation (target step count) | Step count (bowel function, LOS) |
| Wolk 2019 | Germany | RCT | 132 | UGI, HPB, colorectal | o, l (51) | POD 1–5/D, P/ambulation (target step count) | Step count (morbidity rate, LOS) |
6MWT, 6-minute walk test; dis, discharge from hospital; FEV1, forced expiratory volume in 1 s; FVC, forced vital capacity; GI, gastrointestinal; HPB, hepatopancreatobiliary; LOS, duration of hospital stay; n.a., not assessed; oberv., observational; POD, postoperative day; PPC, postoperative pulmonary complications; prosp., prospective; QoL, quality of life; RCT, randomized clinical trial; retro., retrospective; UGI, upper gastrointestinal. *o, open; l, laparoscopic; r, robot-assisted (percentage of the respective minimally invasive technique referred to the total cohort if the data were available). †Mobilization protocol was encouraged during the indicated postoperative days by education only (E), digital advice (D) or healthcare professionals (P). Details of the mobilization protocols in RCTs are presented in Table S3, Supplementary material. ‡Assessed 4 weeks after surgery. §These articles both report the results of the same RCT and were combined in this table.
| Study . | Country . | Design . | Included patients (n) . | Field of surgery . | Technique* . | Intervention† (duration/assistance/type) . | Primary outcome (sec. outcomes) . |
|---|---|---|---|---|---|---|---|
| Ahn 2013 | Korea | RCT | 41 | Colon | o, l (77), r (6) | POD 1–dis/P/stretching and ambulation twice daily | LOS (time to flatus, morbidity rate, walking distance) |
| Fiore 2017, Balvardi 2021§ | Canada | RCT | 100 | Colorectal | o, l (81) | POD 0–dis/P/ambulation 3 times daily | 6MWT‡ (FVC, FEV1, PPC, step count, LOS, GI recovery, morbidity rate) |
| Bhatt 2017 | Ireland | Prosp. observ. | 60 | UGI, hepatobiliary, colorectal | o, l | POD 2–dis/P/pedal exerciser twice daily | PPC (dyspnoea score, LOS) |
| Boerrigter 2022 | Netherlands | Retro. observ. | 373 | UGI, HPB, colorectal | n.a. | POD 1–3/P/increased ambulation targets (max. 1125 m daily) | Ceiling effect of target goals (LOS) |
| de Almeida 2017 | Brazil | RCT | 108 | UGI, HPB, colorectal, urological (3–6%) | o, l (22) | POD 1–dis/P/physical exercises including walking/strengthening exercise/cycle ergometry twice daily | Inability to ambulate at POD 5 (6MWT, fatigue, QoL, morbidity rate, LOS) |
| Fagevik Olsén 2021 | Sweden | RCT | 83 | Pancreatic | o | POD 0–dis/P/ambulation and cycle ergometry (2–3 times daily) | Oxygenation (pulmonary function, pneumonia rate, LOS) |
| Grass 2018 | Switzerland | Retro. | 1170 | Colorectal | o, l (58) | POD 1–3/E/ambulation out of bed ≥6 h on POD 1 | Compliance to mobilization (morbidity rate, LOS) |
| Koyuncu 2021 | Turkey | Prosp. | 42 | UGI, pancreatic, colorectal | n.a. | POD 0/E/ambulation 2 h out of bed on POD 0 | Mobilization time (sleep quality, bowel function, LOS) |
| Ni 2018 | China | RCT | 120 | Hepatic | n.a. | POD 1–5/P/ambulation beginning POD 2, 2–5 times daily | Step count (pain, sleeping state, bowel function, morbidity rate, LOS) |
| Ni 2022 | China | RCT | 120 | Hepatic | n.a. | POD 1–5/P/ambulation beginning POD 2, 2–5 times daily | Sleep quality (pain, bowel function, step count, LOS) |
| Nishijima 2020 | Japan | Retro. | 718 | UGI (excl. oesophagus), HPB, colon | o, l (50) | POD 1–dis/P/ambulation >20 m (during POD 1–2 versus later) | Morbidity rate (LOS) |
| Rosowicz 2022 | USA | Retro. | 291 | Colorectal | o, l (76) | POD 0–dis/E/ambulation (within 24 h versus later begin) | Morbidity rate (LOS) |
| Van der Leeden 2016 | Netherlands | Retro. | 116 | UGI, hepatic, colorectal, other | o, l (24) | POD 0–5/P/ambulation target goals (scheduled distance) | PPC (LOS, 6MWT) |
| Wiklund 2015 | Sweden | RCT | 66 | Gastric bypass (bariatric) | l | POD 1–7/D, E/ambulation (target step count) | Step count (bowel function, LOS) |
| Wolk 2019 | Germany | RCT | 132 | UGI, HPB, colorectal | o, l (51) | POD 1–5/D, P/ambulation (target step count) | Step count (morbidity rate, LOS) |
| Study . | Country . | Design . | Included patients (n) . | Field of surgery . | Technique* . | Intervention† (duration/assistance/type) . | Primary outcome (sec. outcomes) . |
|---|---|---|---|---|---|---|---|
| Ahn 2013 | Korea | RCT | 41 | Colon | o, l (77), r (6) | POD 1–dis/P/stretching and ambulation twice daily | LOS (time to flatus, morbidity rate, walking distance) |
| Fiore 2017, Balvardi 2021§ | Canada | RCT | 100 | Colorectal | o, l (81) | POD 0–dis/P/ambulation 3 times daily | 6MWT‡ (FVC, FEV1, PPC, step count, LOS, GI recovery, morbidity rate) |
| Bhatt 2017 | Ireland | Prosp. observ. | 60 | UGI, hepatobiliary, colorectal | o, l | POD 2–dis/P/pedal exerciser twice daily | PPC (dyspnoea score, LOS) |
| Boerrigter 2022 | Netherlands | Retro. observ. | 373 | UGI, HPB, colorectal | n.a. | POD 1–3/P/increased ambulation targets (max. 1125 m daily) | Ceiling effect of target goals (LOS) |
| de Almeida 2017 | Brazil | RCT | 108 | UGI, HPB, colorectal, urological (3–6%) | o, l (22) | POD 1–dis/P/physical exercises including walking/strengthening exercise/cycle ergometry twice daily | Inability to ambulate at POD 5 (6MWT, fatigue, QoL, morbidity rate, LOS) |
| Fagevik Olsén 2021 | Sweden | RCT | 83 | Pancreatic | o | POD 0–dis/P/ambulation and cycle ergometry (2–3 times daily) | Oxygenation (pulmonary function, pneumonia rate, LOS) |
| Grass 2018 | Switzerland | Retro. | 1170 | Colorectal | o, l (58) | POD 1–3/E/ambulation out of bed ≥6 h on POD 1 | Compliance to mobilization (morbidity rate, LOS) |
| Koyuncu 2021 | Turkey | Prosp. | 42 | UGI, pancreatic, colorectal | n.a. | POD 0/E/ambulation 2 h out of bed on POD 0 | Mobilization time (sleep quality, bowel function, LOS) |
| Ni 2018 | China | RCT | 120 | Hepatic | n.a. | POD 1–5/P/ambulation beginning POD 2, 2–5 times daily | Step count (pain, sleeping state, bowel function, morbidity rate, LOS) |
| Ni 2022 | China | RCT | 120 | Hepatic | n.a. | POD 1–5/P/ambulation beginning POD 2, 2–5 times daily | Sleep quality (pain, bowel function, step count, LOS) |
| Nishijima 2020 | Japan | Retro. | 718 | UGI (excl. oesophagus), HPB, colon | o, l (50) | POD 1–dis/P/ambulation >20 m (during POD 1–2 versus later) | Morbidity rate (LOS) |
| Rosowicz 2022 | USA | Retro. | 291 | Colorectal | o, l (76) | POD 0–dis/E/ambulation (within 24 h versus later begin) | Morbidity rate (LOS) |
| Van der Leeden 2016 | Netherlands | Retro. | 116 | UGI, hepatic, colorectal, other | o, l (24) | POD 0–5/P/ambulation target goals (scheduled distance) | PPC (LOS, 6MWT) |
| Wiklund 2015 | Sweden | RCT | 66 | Gastric bypass (bariatric) | l | POD 1–7/D, E/ambulation (target step count) | Step count (bowel function, LOS) |
| Wolk 2019 | Germany | RCT | 132 | UGI, HPB, colorectal | o, l (51) | POD 1–5/D, P/ambulation (target step count) | Step count (morbidity rate, LOS) |
6MWT, 6-minute walk test; dis, discharge from hospital; FEV1, forced expiratory volume in 1 s; FVC, forced vital capacity; GI, gastrointestinal; HPB, hepatopancreatobiliary; LOS, duration of hospital stay; n.a., not assessed; oberv., observational; POD, postoperative day; PPC, postoperative pulmonary complications; prosp., prospective; QoL, quality of life; RCT, randomized clinical trial; retro., retrospective; UGI, upper gastrointestinal. *o, open; l, laparoscopic; r, robot-assisted (percentage of the respective minimally invasive technique referred to the total cohort if the data were available). †Mobilization protocol was encouraged during the indicated postoperative days by education only (E), digital advice (D) or healthcare professionals (P). Details of the mobilization protocols in RCTs are presented in Table S3, Supplementary material. ‡Assessed 4 weeks after surgery. §These articles both report the results of the same RCT and were combined in this table.
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