Prehabilitation and acute postoperative physical activity in patients undergoing radical prostatectomy: a secondary analysis from an RCT

Sports Medicine - Open

Guillaume Bousquet-Dion¹  Rashami Awasthi¹  Franco Carli²  Paty Lopez³  Darren Au³  Daniel Santa Mina⁴  William J. Hilton⁵  Andrew G. Matthew⁶  Karim Ladha⁶ 

[1] 0000 0000 9064 4811, grid.63984.30, Department of Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada;0000 0000 9064 4811, grid.63984.30, Department of Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada;0000 0004 1936 8649, grid.14709.3b, Department of Surgery, Division of Urology, McGill University, Montreal, Quebec, Canada;0000 0004 1936 8649, grid.14709.3b, Department of Anesthesia, Faculty of Medicine, McGill University, Montreal, Quebec, Canada;0000 0001 2157 2938, grid.17063.33, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada;0000 0004 0474 0428, grid.231844.8, University Health Network, Toronto, Ontario, Canada;0000 0001 2157 2938, grid.17063.33, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada;0000 0004 0474 0428, grid.231844.8, University Health Network, Toronto, Ontario, Canada;0000 0001 2157 2938, grid.17063.33, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;0000 0004 0474 0428, grid.231844.8, University Health Network, Toronto, Ontario, Canada;0000 0004 0474 0428, grid.231844.8, University Health Network, Toronto, Ontario, Canada;0000 0001 2157 2938, grid.17063.33, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;

关键词: Surgery;    Physical activity;    Prehabilitation;    Prostate cancer;    Radical prostatectomy;    Accelerometry;   

DOI  :  10.1186/s40798-019-0191-2

来源: publisher

【 摘 要 】

BackgroundPhysical activity via early mobilization after surgery is recommended to help reduce the risk of postoperative adverse effects and to improve recovery. We explored whether prehabilitation is associated with differences in physical activity during the postoperative inpatient stay and the week after discharge in men undergoing abdominal surgery.MethodsThis study was a pre-planned secondary analysis of a larger randomized controlled trial of home-based exercise prehabilitation versus control for men undergoing radical prostatectomy. Twenty-one participants in both the prehabilitation and control groups wore accelerometers from postoperative day 1 until 7 days after discharge. Mean physical activity (minutes) during postoperative day 1 (inpatient) and 1 week following hospital discharge (outpatient) were estimated using ANCOVA. Pearson’s correlation coefficients were conducted for mean in- an outpatient physical activity with length of stay and changes in 6-min walk test (6MWT) over the course of the prehabilitation period.ResultsNineteen participants in each group provided usable accelerometry data for analysis. Inpatient physical activity of light or greater activity during postoperative day 1 for prehabilitation and control groups were 442.5 ± 40.2 and 324.0 ± 40.2 min, respectively (∆ = 117.5 ± 57.8 min, 95%CI [0.04, 235.0]). During the outpatient period, mean daily physical activity was 448.4 ± 31.2 and 491.42 ± 31.2 min for prehabilitation and control participants, respectively (∆ = 42.6 ± 44.9 min; 95% CI [− 134.0, 48.7]). There were no correlations between in- or outpatient physical activity and preoperative changes in 6MWT or length of stay.ConclusionsAccelerometry-based measurement of physical activity in the acute postoperative period is feasible in older men undergoing abdominal surgery. Prehabilitation may be associated with increased inpatient physical activity; however, larger and longer studies are needed to elucidate any associated effects on clinical and patient outcomes.Trial registrationClinicaltrials.gov: NCT02036684 registered January 15, 2014.

【 授权许可】

CC BY