Can physical activity lessen pain after bariatric surgery?

As a nurse, Nanna Christiansen has witnessed patients' first moments of awakening from bariatric surgery. She is a PhD student at the Department of Regional Health Research and Esbjerg Hospital. She has often observed that patients endure pain that traditional pain management strategies fail to reduce effectively. The medications available are insufficient, leaving patients to reach their maximum allowable dosage without achieving relief from pain.

With funding of just under two million from the Novo Nordisk Foundation, Nanna Christiansen is now able to begin her PhD project at the Department of Regional Health Research and Esbjerg Hospital – University Hospital of Southern Denmark. The research focuses on the significance of promptly mobilising patients soon after undergoing abdominal surgery for obesity. Here, 'mobilisation' refers to the technical term for initiating movement.

More knowledge on the importance of mobilisation

-I find this group of patients to be highly motivated, states Nanna Christiansen. Typically, they have spent a considerable amount of time preparing for the surgery, fully aware that for many, it is not without pain.

-Assessing pain and assisting patients in managing it, also referred to as 'coping,' is a fundamental aspect of our professional duty as nurses, states Nanna Christiansen. She is now set to explore whether variations in movement are associated with differences in patients' experiences of pain.

Esbjerg Hospital is one of the few places in Denmark with specialised expertise in managing the health of individuals with obesity. Nanna Christiansen is now adding further insights, which will include analysing movement measurements in conjunction with questionnaires that assess quality of life and pain management strategies.

Helping patients after discharge

It is customary to be on sick leave for 2-4 weeks after bariatric surgery, with the initial phase spent in the hospital. For the 112 patients consenting to participate in the study, Nanna Christiansen will engage in discussions about pain and mobilisation in the Recovery Department and will also conduct follow-ups with participants upon their transfer to the ward. There, she is equipped to undertake quantitative pain measurement, evaluate functional levels, and monitor physical activity using pedometers and other measurement devices.

Patients are typically discharged the day following their surgery. However, this research project includes a component where patients receive follow-up care from a municipal physiotherapist, as arranged with certain municipalities. This physiotherapist conducts follow-ups mere days after discharge, providing training, guidance, and recommendations for lifestyle modifications over a four-week period.

-This segment of the project was crafted through a distinctive partnership with leaders and therapists from Esbjerg Municipality, who have wholeheartedly dedicated themselves to the initiative, despite not usually working with this patient demographic within their scope, states Nanna Christiansen.

From the inclusion of the first patient, scheduled after Easter, to the completion of the last patient's participation, Nanna anticipates the process will span two years.