Ambulation, or the ability to walk or move from one place to another, plays a critical role in maintaining overall health and well-being.
Whether for rehabilitation purposes or to enhance mobility and independence, ambulation is a key aspect of recovery, especially after surgeries, injuries, or prolonged periods of immobility.
It helps improve cardiovascular health, strengthen muscles, support joint function, and reduce the risk of complications such as blood clots and pneumonia.
For patients and healthcare professionals alike, understanding the importance of ambulation and implementing it safely can make a significant difference in achieving long-term recovery goals and improving the quality of life.
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What is Ambulation?
Ambulation refers to the act of walking or moving from one place to another, typically on foot. In healthcare, the term is commonly used to describe a patient’s ability to move independently or with assistance as part of their recovery process.
Ambulation plays a crucial role in rehabilitation, helping to improve circulation, enhance muscle strength, and prevent complications associated with immobility, such as blood clots, pneumonia, and muscle atrophy.
In clinical settings, ambulation can be encouraged through various methods, including supervised walking, the use of assistive devices like walkers or canes, and physical therapy exercises designed to restore balance, coordination, and strength.
Importance of Early Ambulation
Ambulation after surgery is essential, as it plays a crucial role in the recovery process and helps prevent potential complications.
Some of the key benefits of early ambulation after surgery include:
- Enhanced circulation: Walking after surgery stimulates blood flow and helps reduce the risk of blood clots (deep vein thrombosis) that can form due to prolonged immobility. Improved circulation also promotes oxygen and nutrient delivery to healing tissues, supporting the recovery process.
- Respiratory function: Ambulation encourages deep breathing, which helps clear the lungs, reduces the risk of pneumonia, and improves overall respiratory function. This is particularly important after surgeries that involve general anesthesia, as patients may be more prone to breathing complications.
- Bowel function: Walking can help stimulate bowel movements and prevent postoperative constipation, a common side effect of anesthesia and pain medications. Regular ambulation aids in restoring normal gastrointestinal function.
- Muscle strength and joint mobility: Early ambulation helps maintain muscle strength and joint flexibility, preventing stiffness and muscle atrophy that can result from prolonged bed rest.
- Pain management: Gentle ambulation can help alleviate postoperative pain by promoting blood flow, reducing inflammation, and releasing endorphins, the body’s natural pain-relievers.
- Faster recovery: Ambulation supports overall healing and can speed up the recovery process, allowing patients to regain their independence and return to daily activities more quickly.
- Reduced risk of complications: Early ambulation helps prevent complications such as bedsores, urinary tract infections, and muscle weakness, which can arise from prolonged immobility.
- Improved mental health: Walking can help alleviate feelings of anxiety, depression, or stress associated with surgery and recovery, promoting emotional well-being and a more positive outlook.
Healthcare professionals often encourage patients to start ambulating as soon as it is safe and feasible after surgery, based on the type of procedure and individual factors. A gradual increase in activity levels, under the guidance of medical professionals, helps ensure a successful and healthy recovery process.
Problems That Can Occur When There is No Ambulation
The absence of ambulation during postoperative care or rehabilitation can have several adverse effects on a patient’s recovery and overall health. Prolonged immobility following surgery can increase the risk of developing deep vein thrombosis (DVT), as blood clots are more likely to form when circulation is compromised.
In addition, a lack of ambulation can lead to respiratory complications, such as pneumonia, due to reduced lung function and ineffective clearance of secretions. Patients may also experience delayed gastrointestinal function recovery, resulting in postoperative constipation and discomfort.
Furthermore, muscle weakness, atrophy, and joint stiffness can develop due to inactivity, making it more challenging to regain mobility and functional independence. This can prolong the rehabilitation process and hinder a patient’s return to their activities of daily living.
The absence of ambulation can also exacerbate feelings of anxiety, depression, and stress associated with surgery and recovery, negatively impacting emotional well-being.
Note: The lack of ambulation during postoperative care or rehabilitation can lead to a range of physical and emotional complications, which can hinder the healing process and diminish the patient’s overall quality of life.
Steps for Ambulating a Patient
Here are the steps for ambulating a patient to help ensure a successful and safe recovery process:
- Lower the bed to a comfortable height and secure its wheels to prevent movement.
- Ensure all medical equipment (such as IV lines, nasogastric tubes, and surgical drains) is situated near the patient to avoid dislodging during the ambulation process.
- Gently move the patient toward the side of the bed closest to them.
- Support the patient in sitting up by placing one arm beneath the shoulder nearest to you and the other beneath the farthest armpit.
- With one hand under the patient’s farthest knee, carefully rotate them so that their legs hang off the side of the bed.
- Allow the patient to remain in this position until any dizziness or lightheadedness subsides, encouraging them to look straight ahead rather than at the floor.
- Help the patient transition to a standing position while providing necessary support.
- Remind the patient to breathe calmly and steadily as they adjust to standing upright.
- Accompany the patient during their walk, offering no support, minimal support, or moderate support as needed (for moderate support, two healthcare providers should assist the patient, one on each side).
- Keep the initial walking session brief, lasting no more than 5 to 10 minutes.
Note: Keep in mind that the patient’s ambulation schedule, walking distance, and support needs should be tailored to their individual health status.
Assistive Devices for Ambulation
Assistive devices for ambulation are designed to support individuals with mobility limitations, helping them maintain or regain their ability to walk safely and independently.
There are several types of assistive devices available, each catering to different needs and levels of support. Some common assistive devices for ambulation include:
- Canes: Canes provide additional support and balance for individuals with mild to moderate mobility issues. They come in various styles, such as single-point canes, quad canes (with four points of contact), and offset canes, which distribute weight more evenly.
- Walkers: Walkers offer greater stability and support than canes, making them suitable for individuals with significant balance or strength limitations. They are available in different styles, including standard walkers, two-wheel walkers, and four-wheel walkers (also known as rollators), which come with additional features like hand brakes, seats, and storage compartments.
- Crutches: Crutches help redistribute body weight from the lower limbs to the upper body, allowing individuals with leg injuries or disabilities to maintain mobility. There are several types of crutches, including axillary (underarm) crutches, forearm (or elbow) crutches, and platform crutches, each designed for different levels of support and comfort.
- Gait trainers: Gait trainers are specialized devices designed to support and facilitate ambulation in individuals with significant mobility impairments, such as those with cerebral palsy, traumatic brain injury, or spinal cord injury. They often include additional support features like harnesses, trunk supports, and adjustable components to accommodate individual needs.
- Knee walkers: Also known as knee scooters, these devices are designed for individuals with foot, ankle, or lower leg injuries who cannot bear weight on the affected limb. Knee walkers allow users to rest their injured leg on a cushioned platform while using their uninjured leg to propel themselves forward.
- Prosthetic limbs: Prosthetic limbs replace a missing leg or foot, enabling individuals with amputations to regain their ability to walk. Modern prosthetics are highly customizable and can be designed to accommodate various activity levels and individual needs.
Note: Selecting the appropriate assistive device for ambulation depends on factors such as the individual’s specific mobility limitations, strength, balance, and personal preferences.
FAQs About Ambulation
Ambulation is Another Term for What?
Ambulation is another term for walking or moving from one place to another, typically on foot. It refers to the act of walking or moving independently and is a critical aspect of human mobility.
Ambulation is essential for carrying out daily activities, maintaining physical fitness, and promoting overall health and well-being.
Why is Ambulation Important for Recovery?
Ambulation is important for recovery because it promotes circulation, enhances respiratory function, stimulates bowel function, maintains muscle strength and joint mobility, and helps manage pain.
By encouraging movement and activity, ambulation can accelerate the healing process, prevent complications related to immobility, and support a patient’s return to daily activities and independence.
Does Ambulation Help With Pain?
Yes, ambulation can help with pain management. Gentle walking or movement can increase blood flow, reduce inflammation, and stimulate the release of endorphins, the body’s natural pain-relievers.
Ambulation can also help alleviate muscle stiffness and discomfort that may arise from prolonged immobility, leading to an overall reduction in pain levels.
How Does Ambulation Help Pneumonia?
Ambulation helps pneumonia by encouraging deep breathing and coughing, which aid in clearing mucus and secretions from the lungs. Walking or moving around can improve lung function, increase oxygenation, and prevent the buildup of fluid in the lungs.
This, in turn, helps reduce the risk of pneumonia or speed up recovery from respiratory infections. Ambulation is especially important after surgery or during periods of immobility when patients are more prone to developing pneumonia.
What are the Benefits of Ambulation and Transfer Services?
Ambulation and transfer services are designed to assist individuals with mobility limitations in safely moving from one place to another, both within and outside their living environment.
The benefits of these services include maintaining or improving mobility and independence, reducing the risk of falls and injuries, enhancing physical and mental well-being, and promoting social engagement.
By providing support, guidance, and personalized care, ambulation and transfer services enable individuals to continue participating in daily activities and maintain their quality of life despite mobility challenges.
Does Ambulation Help with Edema?
Yes, ambulation can help with edema (swelling) by promoting circulation and preventing fluid buildup in the limbs. Walking or moving around encourages blood flow and helps push excess fluid back into the bloodstream, reducing swelling in the affected areas.
Ambulation can be particularly beneficial for individuals with lower extremity edema, as standing or sitting for prolonged periods can exacerbate fluid accumulation in the legs and feet.
In addition to ambulation, elevation and compression therapy may also be recommended to manage edema, depending on the underlying cause and severity.
Does Ambulation Help with Urinary Retention?
Ambulation can help with urinary retention by promoting circulation, stimulating bowel function, and reducing the side effects of prolonged immobility.
Walking or moving around can aid in the relaxation of pelvic floor muscles and support the normal function of the urinary system, facilitating the flow of urine. In some cases, ambulation may help alleviate mild urinary retention caused by constipation or reduced physical activity.
However, if urinary retention persists or is caused by an underlying medical condition, it is essential to consult a healthcare professional for appropriate diagnosis and treatment.
How Does Ambulation Help With Breathing?
Ambulation helps with breathing by encouraging deeper breaths, improving lung function, and increasing overall oxygenation. As you walk or move around, your body’s demand for oxygen increases, prompting you to take deeper, more effective breaths.
This increased respiratory activity helps clear mucus and secretions from the lungs, reducing the risk of respiratory infections like pneumonia. Ambulation also promotes better circulation, which in turn, supports the efficient delivery of oxygen throughout the body.
Does Ambulation Require a Physician’s Order?
Ambulation does not generally require a physician’s order for healthy individuals or those with mild mobility limitations.
However, if a person has recently undergone surgery, experienced an injury, or has a medical condition that affects their mobility, it is advisable to consult with a healthcare professional before starting or resuming ambulation.
A physician or physical therapist can provide guidance on the appropriate level of activity, recommend assistive devices if necessary, and help design a personalized rehabilitation plan to ensure safe and effective ambulation.
Why is Ambulation Important After Surgery?
Ambulation is important after surgery because it promotes circulation, enhances respiratory function, stimulates bowel function, maintains muscle strength and joint mobility, and helps manage pain.
Early ambulation after surgery can reduce the risk of complications, such as blood clots, pneumonia, and constipation, which are associated with prolonged immobility.
Walking or moving around can also accelerate the healing process, support a patient’s return to daily activities, and improve overall recovery outcomes.
Healthcare professionals typically encourage patients to start ambulating as soon as it is safe and feasible after surgery, based on the type of procedure and individual factors.
Final Thoughts
Incorporating ambulation into daily routines or rehabilitation programs is a vital step toward enhancing mobility, preventing complications, and promoting overall well-being.
Whether someone is recovering from an illness or working to maintain their independence, regular movement supports both physical and mental health.
By prioritizing safe and consistent ambulation, individuals can experience improved strength, endurance, and confidence, reinforcing their journey toward better health and an active lifestyle.
Written by:
John Landry is a registered respiratory therapist from Memphis, TN, and has a bachelor's degree in kinesiology. He enjoys using evidence-based research to help others breathe easier and live a healthier life.
References
- Fisher SR, Kuo YF, Graham JE, Ottenbacher KJ, Ostir GV. Early ambulation and length of stay in older adults hospitalized for acute illness. Arch Intern Med. 2010.
- Huang J, Shi Z, Duan FF, Fan MX, Yan S, Wei Y, Han B, Lu XM, Tian W. Benefits of Early Ambulation in Elderly Patients Undergoing Lumbar Decompression and Fusion Surgery: A Prospective Cohort Study. Orthop Surg. 2021.
- Doherty-King B, Bowers BJ. Attributing the responsibility for ambulating patients: a qualitative study. Int J Nurs Stud. 2013.