title: Are postoperative activity restrictions evidence-based?
abstract: BACKGROUND
  Many surgeons restrict activities postoperatively. Intra-abdominal pressure during some activities is known; however, many everyday activities have not been studied. Our aim was to compare the intra-abdominal pressures created during unavoidable physical activities with activities that commonly are restricted after surgery.
  
  
  METHODS
  Nine healthy subjects (2 men, 7 women; age, 28 +/- 7 y) performed 5 repetitions of various activities while their intravesicular pressures was measured.
  
  
  RESULTS
  The resting intravesicular pressure was 17 +/- 5 mm Hg, increasing to a maximum of 112 +/- 35 mm Hg during forceful coughing. The intravesicular pressure increase was greatest with forceful coughing, followed by the Valsalva maneuver.
  
  
  CONCLUSIONS
  The results suggest that the greatest increase in intra-abdominal pressure occurs during some unavoidable activities. Based on this study, postoperative restrictions may be unnecessary. Further experience based on a larger study is needed to answer this important clinical question.
authors.affiliation: Department of Surgery, Synergy Medical Education Alliance, 1000 Houghton Ave., Saginaw, MI 48602, USA. rguttormson@synergymedical.org
authors.forename: Robert
authors.initials: R
authors.lastname: Guttormson
authors.forename: James
authors.initials: J
authors.lastname: Tschirhart
authors.forename: Dennis
authors.initials: D
authors.lastname: Boysen
authors.forename: Kurt
authors.initials: K
authors.lastname: Martinson
mesh_terms: D034841:Abdominal Cavity / Q000502:physiology; D000328:Adult; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D011182:Postoperative Care; D011312:Pressure; D001743:Urinary Bladder / Q000502:physiology*