After surgery or a period of bed rest, patients must begin the gradual return to full ambulation. When it’s begun promptly and properly, progressive ambulation thwarts many of the complications of prolonged inactivity.

Complications prevented by early progressive ambulation include respiratory stasis and hypostatic pneumonia; circulatory stasis, thrombophlebitis, and emboli; urine retention, urinary tract infection, urinary stasis, and calculus formation; abdominal distention, constipation, and decreased appetite; and sensory deprivation.¹ Progressive ambulation also helps restore the patient’s sense of equilibrium and enhances his self-confidence and self-image.

Progressive ambulation begins with dangling the patient’s feet over the edge of the bed and progresses to seating him in an armchair or wheelchair, walking around the room with him, and then walking with him in the halls until he can walk by himself. The patient’s progress depends on his physical condition and his tolerance. Successful return to full ambulation requires correct body mechanics, careful patient observation, and open communication between patient, doctor, and nurse.