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Prehabilitation and acute postoperative physical activity in patients undergoing radical prostatectomy: a secondary analysis from an RCT.
Sports Med Open 2019; 5(1):18SM

Abstract

BACKGROUND

Physical 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.

METHODS

This 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.

RESULTS

Nineteen 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.

CONCLUSIONS

Accelerometry-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 REGISTRATION

Clinicaltrials.gov: NCT02036684 registered January 15, 2014.

Authors+Show Affiliations

Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada. darren.au@mail.utoronto.ca. University Health Network, Toronto, Ontario, Canada. darren.au@mail.utoronto.ca.University Health Network, Toronto, Ontario, Canada. Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada. University Health Network, Toronto, Ontario, Canada.University Health Network, Toronto, Ontario, Canada.Department of Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada.Department of Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada.University Health Network, Toronto, Ontario, Canada. Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.Department of Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada. Department of Surgery, Division of Urology, McGill University, Montreal, Quebec, Canada. Department of Anesthesia, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada. University Health Network, Toronto, Ontario, Canada. Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31119491

Citation

Au, Darren, et al. "Prehabilitation and Acute Postoperative Physical Activity in Patients Undergoing Radical Prostatectomy: a Secondary Analysis From an RCT." Sports Medicine - Open, vol. 5, no. 1, 2019, p. 18.
Au D, Matthew AG, Lopez P, et al. Prehabilitation and acute postoperative physical activity in patients undergoing radical prostatectomy: a secondary analysis from an RCT. Sports Med Open. 2019;5(1):18.
Au, D., Matthew, A. G., Lopez, P., Hilton, W. J., Awasthi, R., Bousquet-Dion, G., ... Santa Mina, D. (2019). Prehabilitation and acute postoperative physical activity in patients undergoing radical prostatectomy: a secondary analysis from an RCT. Sports Medicine - Open, 5(1), p. 18. doi:10.1186/s40798-019-0191-2.
Au D, et al. Prehabilitation and Acute Postoperative Physical Activity in Patients Undergoing Radical Prostatectomy: a Secondary Analysis From an RCT. Sports Med Open. 2019 May 22;5(1):18. PubMed PMID: 31119491.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prehabilitation and acute postoperative physical activity in patients undergoing radical prostatectomy: a secondary analysis from an RCT. AU - Au,Darren, AU - Matthew,Andrew G, AU - Lopez,Paty, AU - Hilton,William J, AU - Awasthi,Rashami, AU - Bousquet-Dion,Guillaume, AU - Ladha,Karim, AU - Carli,Franco, AU - Santa Mina,Daniel, Y1 - 2019/05/22/ PY - 2019/01/21/received PY - 2019/05/08/accepted PY - 2019/5/24/entrez PY - 2019/5/24/pubmed PY - 2019/5/24/medline KW - Accelerometry KW - Physical activity KW - Prehabilitation KW - Prostate cancer KW - Radical prostatectomy KW - Surgery SP - 18 EP - 18 JF - Sports medicine - open JO - Sports Med Open VL - 5 IS - 1 N2 - BACKGROUND: Physical 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. METHODS: This 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. RESULTS: Nineteen 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. CONCLUSIONS: Accelerometry-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 REGISTRATION: Clinicaltrials.gov: NCT02036684 registered January 15, 2014. SN - 2199-1170 UR - https://www.unboundmedicine.com/medline/citation/31119491/Prehabilitation_and_acute_postoperative_physical_activity_in_patients_undergoing_radical_prostatectomy:_a_secondary_analysis_from_an_RCT_ L2 - https://dx.doi.org/10.1186/s40798-019-0191-2 DB - PRIME DP - Unbound Medicine ER -