Quantifying postoperative mobilisation following oesophagectomy

Hussey, Juliette; Yang, Tianzhen; Dowds, Joanne; O’Connor, Louise; Reynolds, John V.; Guinan, Emer

doi:10.1016/j.physio.2018.08.004

Cited by 16 publications

(8 citation statements)

References 35 publications

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“…Similarly to our findings, Estrup et al [23] found little correlation (r 2 = 0.14-0.25, P < 0.017) between the activity counts and the CPAx among ICU survivors who had low activity time. Our study found that activity time was equivalent to 2.5% of the whole ICU stay, which is similar to what Hussey et al found (4%) in patients after surgery [52]. Possibly, the low correlation between the FSS-ICU and, activity counts and activity time could be explained by how little the activity time experienced by patients during the ICU stay is.…”

Section: Discussionsupporting

confidence: 90%

“…Schweickert et al [49] and Schaller et al [50] have shown that critically ill patients participating in early mobilisation programmes that provide more activity time than usual care have lower mortality rates, fewer days with delirium, shorter duration of mechanical ventilation, and better functional performance. Additionally, actigraphy studies have shown that patients tend to increase their activity from their hospital stay up to the post-ICU follow-up [23,51,52]. Consequently, the main hypothesis for this study was that greater time or amount of movement during the ICU stay (actigraphy) would relate to better mobility (FSS-ICU), and also, that greater inactivity time would relate to worse scores in the FSS-ICU.…”

Section: Discussionmentioning

confidence: 94%

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Construct validity of the Functional Status Score for the Intensive Care Unit: a prospective observational study using actigraphy in mechanically-ventilated patients

Camus-Molina

González-Seguel

Castro³

et al. 2020

Preprint

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Background The Functional Status Score for the Intensive Care Unit (FSS-ICU) is a widely used instrument, designed to measure the mobility of critically ill patients that is available in English, Portuguese, Turkish and Spanish. The lack of a gold standard for measuring mobility limits the validation of outcome measures. However, actigraphy, from which measures movement intensity can be derived, is a potential alternative in the intensive care unit (ICU). Thus, this study aimed to assess the construct validity (hypotheses testing) of the FSS-ICU using continuous actigraphy from ICU admission to ICU discharge. Methods This prospective observational study included mechanically-ventilated patients selected from a 12-bed academic medical-surgical ICU. The Chilean-Spanish version of the FSS-ICU was used to evaluate its correlation with activity counts, activity time (>99 counts per minute) and inactivity time (0-99 counts per minute) measured by actigraphy ( GT9X Link ActiGraph). The FSS-ICU was assessed on awakening and at ICU discharge, while actigraphy variables were recorded from ICU admission to ICU discharge. Results Of 92 patients screened, 30 were analysed. The median FSS-ICU was 19 (IQR 10–26) points on awakening and 28.5 (IQR 22–32) at ICU discharge. There was no floor/ceiling effect of the FSS-ICU at awakening (0%/0%) and only a ceiling effect at ICU discharge that was acceptable (0%/10%). Less activity time was associated with better mobility on the FSS-ICU at both awakening (rho = -0.62, P<0.001) and ICU discharge (rho = -0.79, P<0.001). Activity counts and activity time were not correlated as expected with the FSS-ICU. Conclusions The FSS-ICU had a strong correlation with inactivity time during the ICU stay. These findings enhance the available clinimetric properties of the FSS-ICU.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 94%

Construct validity of the Functional Status Score for the Intensive Care Unit: a prospective observational study using actigraphy in mechanically-ventilated patients

Camus-Molina

González-Seguel

Castro³

et al. 2020

Preprint

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“…Propensity-matched patients, n=28 [25, 75%] were similar to those in the present study, in which the factor under consideration was a longer walking distance under the supervision of a physical therapist. Hussey et al 23 ) reported that in postoperative patients with esophageal can-cer, 96% of the day is spent in a sitting or supine position until the fifth day after surgery. The early postoperative period after hepatic resection is also long, and it is likely that patients do not stand or walk except during physical ther-apy.…”

Section: All Patients N=65mentioning

confidence: 99%

Effects of Early Physical Therapist-supervised Walking on Clinical Outcomes after Liver Resection: Propensity Score Matching Analysis

et al. 2021

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The study aimed to demonstrate the significance of early postoperative physical therapy interventions on clinical outcomes by determining the influence of the distance walked under the supervision of a physical therapist in the early postoperative period after liver cancer. Methods: All consecutive patients who underwent surgery for liver cancer between April 2018 and March 2020 were eligible for enrollment in the study. The total walking distance during physical therapy till the third postoperative day was examined. The clinical outcomes comprised duration of postoperative hospital stay, time to independent walking, and occurrence of postoperative complications. For data analysis, the patients were divided into two groups: those who walked more than the median total distance (the long-distance group) and those who walked less than the median distance (the short-distance group). We used propensity score matching to match the background characteristics between the groups. Results: Of the 65 patients who were eligible, 14 patients were included in the two groups each, after matching. The long-distance walking group had a significantly shorter hospital stay (9.0 days vs. 11.0 days, p=0.008) and a shorter time to independent walking (3.5 days vs. 7.5 days, p=0.019) than the short-distance walking group. There were no significant differences in postoperative complications between the two groups (7.1% vs. 42.8%, p=0.08). Conclusion: In the early postoperative period after liver cancer surgery, increasing the walking distance under the supervision of a physical therapist is important for improving clinical outcomes. Further prospective studies are needed to confirm the findings of this study.

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“…Moreover, some studies have shown that early mobilization (EM) in the postoperative period following surgery for the treatment of colon cancer reduces the length of hospital stay 11 . Other benefits of EM include an improvement in lung function, the prevention of muscle hypotrophy and orthostatic hypotension, an improvement in the cardiovascular response to exercise, a faster return of adequate intestinal function and a reduced risk of venous thromboembolism [11][12][13][14][15][16] .…”

Section: Introductionmentioning

confidence: 99%

Analysis of heart rate variability and accelerometry in patients following surgery for the treatment of gastrointestinal cancer

Almeida¹,

Nascimento²,

Neves³

et al. 2021

Cardiorespir Physiother Crit Care Rehabil

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Background: Gastrointestinal cancer is the most prevalent form of cancer worldwide. Surgical treatment interferes with functionality and increases the length of hospital stay. However, studies have shown that early mobilization reduces the length of hospital stay. Aim: To determine the cardiovascular safety and intensity of an adapted protocol for early mobilization in patients following surgery for the treatment of gastrointestinal cancer. Methods: An observational, cross-sectional study was conducted with 24 individuals: 15 in the case group (cancer patients in the post-operative period) and nine in the control group (hospitalized patients without cancer). All participants were submitted to a standardized early mobilization physiotherapeutic protocol. A portable heart rate monitor and accelerometer were used to obtain data on heart rate variability (HRV), analyzing the variables 'interval between consecutive beats' (RR), 'mean heart rate' (HR), 'standard deviation from mean of all normal RR intervals' (SDNN), 'square root of mean of square of differences between consecutive RR intervals' (RMSSD), 'number of RR intervals' (NN50) and 'percentage of adjacent RR intervals with difference in duration greater than 50 ms' (pNN50), and the intensity of physical activity (IPA), analyzing metabolic equivalents (METS), before and after the intervention. Data analysis involved the Student's t-test for the comparison of data with parametric distribution and the Mann-Whitney U test for variables with non-parametric distribution. Results: No statistically significant differences in energy expenditure or IPA percentages were found between groups. Moreover, no significant difference in HRV occurred in the case group, whereas differences in RR, HR and pNN50 variables were found in the control group. Conclusions: Early mobilization for patients following surgery for the treatment of gastrointestinal cancer can be performed without increasing HRV and with energy expenditure and IPA similar to those found in patients without cancer.

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Quantifying postoperative mobilisation following oesophagectomy

Cited by 16 publications

References 35 publications

Construct validity of the Functional Status Score for the Intensive Care Unit: a prospective observational study using actigraphy in mechanically-ventilated patients

Construct validity of the Functional Status Score for the Intensive Care Unit: a prospective observational study using actigraphy in mechanically-ventilated patients

Effects of Early Physical Therapist-supervised Walking on Clinical Outcomes after Liver Resection: Propensity Score Matching Analysis

Analysis of heart rate variability and accelerometry in patients following surgery for the treatment of gastrointestinal cancer

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