OBJECTIVE: To estimate whether specific ambulation goals affect the adequacy or perceived barriers to ambulation in hospitalized surgical patients after major gynecologic surgery. METHODS: One hundred forty-six surgical inpatients were randomized to specific ambulation goals or routine care. We assessed the number of pedometer-recorded steps in the 24 hours preceding discharge as well as patient-identified barriers to ambulation. Groups were compared using the Mann-Whitney U test. RESULTS: Of the 129 participants with outcome data, 12% were discharged without any pedometer-recorded steps. We did not detect an effect of specific ambulation goals by group (routine care: 87 compared with ambulation goals: 80, p = 0.7). The three main barriers to ambulation from a patient perspective were indwelling catheters (38.5%), intravenous poles (28%), and pain (12.5%) The median number of postoperative steps was higher after minimally invasive surgery (143) compared with laparotomy (27) (p = 0.035). CONCLUSION: Approximately 12% of gynecologic surgical patients do not walk while hospitalized despite formal encouragement to ambulate. Ambulation is easily quantified and may improve with attention to modifiable barriers, potentially improving postoperative recovery. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov www.ClinicalTrials.gov NCT01254851. LEVEL OF EVIDENCE: I.
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