The Effect of Early Ambulation after 4 Hours of Bed Rest in Patients with Transarterial Chemoembolization

간동맥 화학색전술을 시행 받은 환자에게서 4시간 절대침상안정 후 조기 이상의 효과

Nam, Sun Hee;Kim, Young-Ju

  • Received : 2015.10.12
  • Accepted : 2016.02.12
  • Published : 2016.02.29


Purpose: This study was to compare the effects of early ambulation to usual care of late ambulation in patients with transarterial chemoembolization on back pain, discomfort, and puncture site complications. Methods: A nonequivalent control pretest-posttest design was used. Total 40 patients were recruited from a gastrointestinal unit of an urban general hospital in Seoul, South Korea. The experimental group began to ambulate after 4 hours of bed rest with a compression bandage after receiving transarterial chemoembolization. The control group stayed in bed with a compression bandage overnight. Results: Back pain was not significantly different between the two group. The experimental group reported significantly lower discomfort than the control group. There was no incidence of bleeding complications on puncture site between two groups. Conclusion: The results of this study showed that early ambulation with four hours of bed rest after femoral sheet removal did not cause bleeding complications compared to the usual care and even decreased patients' level of discomfort due to bed rest. Repetitive research on the effect of short bed rest is warranted for its clinical utilization.


Chemoembolization;Bed rest;Early ambulation;Back pain;Discomfort


  1. Korean Central Cancer Registry. Annual report of cancer statistics in Korea in 2012 [Internet]. 2014. [cited 2015 August 23] Available from:
  2. Jung JW. Transcatheter arterial chemoembolization for hepatocellular carcinoma. Paper presented at The Meeting of the Korean Society of Gastroenterology Postgraduate Course; 2004; Seoul, Korea.
  3. Yun SY. Effects of exercise therapy on back pain of transarterial chemoembolization patients with liver cancer. [master's thesis]. Seoul: Ewha Womans University; 2008.
  4. Black JM, Hawks JH, Keene AM. Medical surgical nursing. Philadelphia: W.B. Saunders; 2004.
  5. Jeong YE, Lee JH, Heo EH, Kwak IO, Park GW, Jang EM, et al. The effect of post-procedures on preventing bleeding and increasing comfort in patients received coronary angiography. Journal of Korean Clinical Nursing Research. 2001;7(2): 67-88.
  6. Lee EJ. A study on perceived discomfort in patients following cardiac catheterization. Journal of Korean Academy of Nursing. 1995;25(1):124-40.
  7. Kang JS, Park SY, Kim EO. The effect of position change on comfort and bleeding after transarterial chemoembolization. Journal of Korean Clinical Nursing Research. 2010;16(1):5-15.
  8. Kim PJ, Jeong JI, Ro JS. Na H, Kim KY, Kim KS, et al. The effect of position change on discomfort and bleeding after coronary angiography. Journal of Korean Clinical Nursing Research. 2009;15(1):19-28.
  9. Park HJ, Sohng KY. Effect of positioning on back pain and comfort of bed rest patients after transhepatic arterial chemoembolization. The Korean Journal of Fundamentals of Nursing. 2005;12(3):317-24.
  10. Pooler-Lunse C, Barkman A, Bock BF. Effects of modified positioning and mobilization on back pain and delayed bleeding in patients who had received heparin and undergone angioplasty: a pilot study. Heart & Lung. 1996;25(2):117-23.
  11. Nam SY, Choi SM. The effects of fowler's position change on back pain and discomfort of the patients following percutaneous coronary intervention. Perspectives in Nursing Science. 2010;7(1):55-64.
  12. Kim MH, Han MJ, Lee JE, Lee JM. Effects of exercise and ice pack therapy on discomfort after percutaneous coronary intervention. Journal of Korean Clinical Nursing Research. 2007; 13(1):185-96.
  13. Han SW. The effects of exercise therapy and transcutaneous electrical nerve stimulation for the alleviation of low back pain after coronary angiography [dissertation]. Seoul: The Catholic University of Korea; 2002.
  14. Park JS, Kim ES, Park CJ. The Effects of the slow stroke back massage on discomfort in patients following percutaneous transluminal coronary angioplasty. Journal of Korean Clinical Nursing Research. 2004;9(2):56-67.
  15. Chair SY, Thompson DR, Li SK. The effect of ambulation after cardiac catheterization on patient outcomes. Journal of Clinical Nursing. 2007;16:212-14.
  16. Gianakos S, Keeling AW, Haines D, Haugh K. Time in bed after electrophysiological procedures (TIBS IV): a pilot study. American Journal of Critical Care. 2004;13(1):56-8.
  17. Steffenino G, Dellavalle A, Ribichini F, Russo P, Conte L, Dutto S, et al. Ambulation three hours elective cardiac catheterization through the femoral artery. Heart. 1996;75:477-80.
  18. Schiks IE, Schoonhoven L, Aengevaeren WR, Nogarede-Hoekstra C, Van Achterberg T, Verheugt FW. Ambulation after femoral sheath removal in percutaneous coronary intervention: a prospective comparison of early vs. late ambulation. Journal of Clinical Nursing, 2009;18(13):1862-70.
  19. Keeling AW, Fisher CA, Haugh KH, Powers ER, Turner MS. Reducing time in bed after percutaneous transluminal coronary angioplasty(TIBS III). American Journal of Critical Care. 2000;9(3):185-7.
  20. Keeling AW, Knight E, Taylor V, Nordt LA. Post-cardiac catheterization time-in-bed study: enhancing patient comfort through nursing research. Applied Nursing Research. 1994;7(1):14-7.
  21. Koch KT, Piek JJ, De Winter RJ, Mulder K, David GK, Lie KI. Early ambulation after coronary angioplasty and stenting with six french guiding catheter and low dose heparin. The American Journal of Cardiology. 1997;80(8):1084-6.
  22. Moeini M, Moradpour F, Babaei S, Rafieian M, Khosravi A. Four hour ambulation after angioplasty is a safe practice method. Iranian Journal of Nursing and Midwifery Research. 2010;15(3):109-14.
  23. Hogan-Miller E, Rustad D, Sendelbach S, Goldenberg I. Effects of three methods of femoral site immobilization on bleeding and comfort after coronary angiogram. American Journal of Critical Care. 1995;4(2):143-8.
  24. Ki EJ. A study for discomfort and bleeding complications during absolute bed rest in patients undergoing percutaneous coronary intervention. [master's thesis]. Suwon: Ajou University; 2001.
  25. Koch KT, Piek JJ, de Winter RJ, Mulder K, Schotborgh CE, Tijssen JGP, et al. Two hour ambulation after coronary angioplasty and stenting with 6F guiding catheter and low dose heparin. Heart. 1999;81(1):53-6.
  26. Rezaei-Adaryani M, Ahmadi F, Asghari-Jafarabadi M. The effect of changing position and early ambulation after cardiac catheterization on patient's outcomes: a single-blind randomized controlled trial. International Journal of Nursing Studies. 2009;46(8):1047-53.


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