Assessing pre- and postoperative activity levels with an accelerometer: a proof of concept study

Eva van der Meij, Hidde P van der Ploeg, Baukje van den Heuvel, Boudewijn J Dwars, W J H Jeroen Meijerink, H Jaap Bonjer, Judith A F Huirne, Johannes R Anema, Eva van der Meij, Hidde P van der Ploeg, Baukje van den Heuvel, Boudewijn J Dwars, W J H Jeroen Meijerink, H Jaap Bonjer, Judith A F Huirne, Johannes R Anema

Abstract

Background: Postoperative recovery after abdominal surgery is measured mostly based on subjective or self-reported data. In this article we aim to evaluate whether recovery of daily physical activity levels can be measured postoperatively with the use of an accelerometer.

Methods: In this multicenter, observational pilot study, 30 patients undergoing laparoscopic abdominal surgery (hysterectomy, adnexal surgery, cholecystectomy and hernia inguinal surgery) were included. Patients were instructed to wear an Actigraph wGT3X-BT accelerometer during one week before surgery (baseline) and during the first, third and fifth week after surgery. Wear time, steps taken and physical activity intensity levels (sedentary, light, moderate and vigorous) were measured. Patients were blinded for the accelerometer outcomes. Additionally, an activity diary comprising patients' self-reported time of being recovered and a list of 18 activities, in which the dates of resumption of these 18 activities were recorded after surgery, was completed by the patient.

Results: Five patients were excluded from analyses because of technical problems with the accelerometer (n = 1) and protocol non-adherence (n = 4). Light, moderate, vigorous, combined moderate and vigorous intensity physical activity (MVPA), and step counts showed a clear recovery curve after surgery. Patients who underwent minor surgery reached their baseline step count and MVPA three weeks after surgery. Patients who underwent intermediate surgery had not yet reached their baseline step count during the last measuring week (five weeks after surgery). The results of the activity diaries showed a fair agreement with the accelerometer results (Cohens Kappa range: 0.273-0.391). Wearing the accelerometer was well tolerated and not regarded as being burdensome by the patients.

Conclusions: The accelerometer appeared to be a feasible way to measure recovery of postoperative physical activity levels in this study and was well tolerated by the patients. The agreement with self-reported physical recovery times was fair.

Keywords: Abdominal surgery; Accelerometer; Adnexal surgery; Cholecystectomy; Hysterectomy; Inguinal hernia surgery; Physical activities; Postoperative recovery.

Figures

Fig. 1
Fig. 1
Flowchart
Fig. 2
Fig. 2
Results of the accelerometer. Figure legend: Intermediate surgery group: laparoscopic hysterectomy. Minor surgery group: adnexal surgery, cholecystectomy, inguinal hernia repair as minor surgery (all laparoscopic). a: Mean step count per measuring week. b: Mean MVPA per measuring week. c: Percentage of patients who reached baseline step count per measuring week. d: Percentage of patients who reached MVPA per measuring week. T0: one week before surgery, T1: one week after surgery, T2: three weeks after surgery, T3: five weeks after surgery
Fig. 3
Fig. 3
Mean step count per day according to type of surgery. Figure legend: Intermediate surgery group: laparoscopic hysterectomy. Minor surgery group: adnexal surgery, cholecystectomy, inguinal hernia repair as minor surgery (all laparoscopic). T0: one week before surgery, T1: one week after surgery, T2: three weeks after surgery, T3: five weeks after surgery
Fig. 4
Fig. 4
Mean step count per day and median reported recovery times (minor surgery group). Figure legend: T0: one week before surgery, T1: one week after surgery, T2: three weeks after surgery, T3: five weeks after surgery

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Source: PubMed

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