Abstract
BackgroundPostoperative 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.MethodsIn 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.ResultsFive 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.ConclusionsThe 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.
Highlights
Postoperative recovery after abdominal surgery is measured mostly based on subjective or self-reported data
There were no major differences in baseline characteristics between patients who were analyzed and those whose data were not used for the analyses, except for Body mass index (BMI) which was higher in the group of patients excluded from analyses
This study has shown that the accelerometer can be used as an objective tool to measure recovery of physical activity levels after laparoscopic abdominal surgery
Summary
Postoperative recovery after abdominal surgery is measured mostly based on subjective or self-reported data. A frequently used standard to measure postoperative recovery is length of hospital stay, because it provides us with a well-defined and objective definition [6]. A wide variation of instruments and outcomes are used to determine postoperative recovery, such as quality of life, satisfaction, pain, recovery indices and return to normal activities [1, 8,9,10]. All of these measuring instruments are subjective and self-reported and prone to measurement bias [1]
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