What are low-intensity exercises after surgery?

Low-Intensity Exercises After Surgery

Low-intensity exercises after surgery should focus on gentle ambulation, breathing exercises, and gradual progression of activity to improve recovery outcomes while preventing complications. 1

Immediate Post-Surgical Period (0-2 weeks)

• Light ambulation with slow, regular walking starting with 10-minute periods and gradually increasing duration as tolerated 2
• Breathing exercises and controlled coughing techniques to prevent pulmonary complications 1
• Break up prolonged sitting with short walking breaks every 20-30 minutes to promote blood flow 2
• Maintain proper posture to avoid strain on the surgical site 2
• Avoid lifting anything heavier than 7-10 pounds to prevent strain on the surgical repair 2

Early Recovery Phase (2-4 weeks)

• Gradually increase walking duration, working up to 30-60 minutes daily 2
• Continue to avoid heavy lifting, straining, and Valsalva maneuvers 2
• Begin gentle range-of-motion exercises for shoulders and neck to prevent stiffness 2, 3
• Low resistance exercises that prevent increased intra-abdominal pressure for patients with abdominal surgery 1

Type-Specific Low-Intensity Exercises

For Abdominal/Gastrointestinal Surgery

• Low resistance exercises that avoid increased intra-abdominal pressure to prevent herniation risk 1
• Avoid aquatic therapy if open wounds or ostomies are present unless appropriate barrier devices are in place 1
• Multimodal postoperative physiotherapy combining breathing exercises and early mobilization 1

For Lung Surgery

• Preoperative pulmonary rehabilitation can optimize exercise tolerance before lung resection surgery 1
• Postoperative walking program with gradual progression 1
• Light strengthening and breathing exercises twice weekly 1
• Interval training (alternating periods of activity with rest) may be better tolerated than continuous exercise for patients with severe limitations 1

For Cardiac Surgery

• Stationary cycling or walking for 10-minute sessions twice daily has shown equal effectiveness in the early postoperative period 4
• Low-intensity weight training (40% of one-repetition maximum) with 10-15 repetitions 1
• Rhythmical exercises performed at moderate to slow controlled speed 5
• Proper breathing techniques (exhaling during exertion) to avoid Valsalva maneuver 5

For Prostate and Gynecological Surgery

• Pre-exercise voiding to manage incontinence 1
• Low resistance exercise with gradual progression 1
• Targeted pelvic floor therapy 1
• Assessment for skeletal muscle wasting in patients exposed to anti-gonadal or glucocorticoid therapies 1

Progression Guidelines

• Begin with low-intensity activities (40% of maximum capacity) and gradually progress as tolerated 1
• When 15 low-intensity repetitions are perceived as "somewhat difficult" (Borg RPE 12-14), increase the weight for the next session 1
• For cardiac patients, target heart rate should be 50-75% of maximum heart rate 1
• Increase duration before increasing intensity 1

Safety Considerations

• Monitor for signs of fatigue, shortness of breath, or pain that may indicate need to modify exercise 2, 6
• Avoid breath-holding during exercise to prevent increased intra-abdominal pressure 5
• For patients with cancer undergoing treatment, monitor blood counts and watch for symptoms of cytopenias 1
• Only 1.3% of rehabilitation sessions after emergency laparotomy resulted in adverse events, which resolved without escalation of medical care 6

Benefits of Early Low-Intensity Exercise

• Reduces length of hospital stay (median 6.0 days vs 6.5 days in colorectal cancer surgery) 7
• Improves patient-perceived readiness for hospital discharge 7
• Preserves muscle mass and prevents loss of range of motion 3
• Reduces post-operative morbidity and improves quality of life 1