SEARCHSYSTEMATIC_REVIEWsurgery, internal medicine

systematic_review·surgery, internal medicine, systematic review, clinical trial, observational study·PMC10227699

Accelerometer-Measured Inpatient Physical Activity and Associated Outcomes After Major Abdominal Surgery: Systematic Review

Interactive Journal of Medical Research · 5 authors, 7 centres

AI SUMMARY

FIDELITY 100%

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

TRACE TO SOURCE

“

TL;DR

This systematic review of 15 studies found that observational studies consistently associated increased postoperative accelerometer-measured physical activity with better outcomes after major abdominal surgery, but randomized controlled trials failed to prove that mobility-enhancing interventions improve outcomes compared with usual care.

Full summary

853 CHARS

This systematic review searched PubMed and Google Scholar to identify studies using accelerometers to measure inpatient physical activity after major abdominal surgery and its association with clinical outcomes. Risk of bias was assessed using RoBANS for observational studies and RoB 2 for RCTs. Among 15 included studies, 93% had high risk of bias, and 73% had sample sizes under 100 participants. However, only one of six RCTs demonstrated improved outcomes with a mobility-enhancing intervention versus usual care. Notably, 67% of mobility-enhancing interventions in RCTs failed to increase postoperative physical activity. The authors speculate that physical activity may be a prognostic indicator rather than a modifiable factor. Most studies used consumer-grade accelerometers and measured only step counts, limiting comparability across studies.

STUDY TYPE

systematic_review

SPECIALTY

surgery

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10227699

Accelerometer-Measured Inpatient Physical Activity and Associated Outcomes After Major Abdominal Surgery: Systematic Review

Interactive Journal of Medical Research

READ THE FULL PAPER

ABSTRACT

Background It remains unclear how inpatient physical activity after major abdominal surgery affects outcomes. Accelerometer research may provide further evidence for postoperative mobilization. Objective We aimed to summarize the current literature evaluating the impact of accelerometer-measured postoperative physical activity on outcomes after major abdominal surgery. Methods We searched PubMed and Google Scholar in October 2021 to conduct a systematic review. Studies were included if they used accelerometers to measure inpatient physical behaviors immediately after major abdominal surgery, defined as any nonobstetric procedures performed under general anesthesia requiring hospital admission. Studies were eligible only if they evaluated the effects of physical activity on postoperative outcomes such as postoperative complications, return of gastrointestinal function, hospital length of stay, discharge destination, and readmissions. We excluded studies involving participants aged <18 years. Risk of bias was assessed using the risk-of-bias assessment tool for nonrandomized studies (RoBANS) for observational studies and the revised Cochrane risk-of-bias tool for randomized trials (RoB 2) for randomized controlled trials (RCTs). Findings were summarized by qualitative synthesis. Results We identified 15 studies. Risk of bias was high in 14 (93%) of the 15 studies. Most of the studies (11/15, 73%) had sample sizes of <100. Of the 15 studies, 13 (87%) included the general surgery population, 1 (7%) was a study of patients who had undergone gynecologic surgery, and 1 (7%) included a mixed (abdominal, thoracic, gynecologic, and orthopedic) surgical population. Of the 15 studies, 12 (80%) used consumer-grade accelerometers to measure physical behaviors. Step count was the most commonly reported physical activity outcome (12/15, 80%). In the observational studies (9/15, 60%), increased physical activity during the immediate postoperative period was associated with earlier return of gastrointestinal function, fewer surgical and pulmonary complications, shorter hospital length of stay, and fewer readmissions. In the RCTs (6/15, 40%), only 1 (17%) of the 6 studies demonstrated improved outcomes (shorter time to flatus and hospital length of stay) when a mobility-enhancing intervention was compared with usual care. Notably, mobility-enhancing interventions used in 4 (67%) of the 6 RCTs did not result in increased postoperative physical activity. Conclusions Although observational studies show strong associations between postoperative physical activity and outcomes after major abdominal surgery, RCTs have not proved the benefit of mobility-enhancing interventions compared with usual care. The overall risk of bias was high, and we could not synthesize specific recommendations for postoperative mobilization. Future research would benefit from improving study design, increasing methodologic rigor, and measuring physical behaviors beyond step counts to understand the impact of postoperative mobilization on outcomes after major abdominal surgery.

CITATION EXPORT

Mikita Fuchita, Kyle J Ridgeway, Clinton Kimzey et al.. Accelerometer-Measured Inpatient Physical Activity and Associated Outcomes After Major Abdominal Surgery: Systematic Review. Interactive Journal of Medical Research. (2023). https://doi.org/10.2196/46629

AUTHORS

5 · 7 CENTRES

Mikita Fuchita, Kyle J Ridgeway, Clinton Kimzey, Edward L Melanson, Ana Fernandez-Bustamante

1 Department of Anesthesiology University of Colorado Anschutz Medical Campus Aurora, CO United States
2 Department of Inpatient Rehabilitation Therapy University of Colorado Hospital University of Colorado Health Aurora, CO United States
3 Department of Physical Medicine and Rehabilitation University of Colorado Anschutz Medical Campus Aurora, CO United States
4 University of Colorado School of Medicine University of Colorado Anschutz Medical Campus Aurora, CO United States
5 Department of Medicine Division of Endocrinology and Metabolism University of Colorado Anschutz Medical Campus Aurora, CO United States
6 Department of Medicine Division of Geriatric Medicine University of Colorado Anschutz Medical Campus Aurora, CO United States
7 Eastern Colorado Veterans Affairs Geriatric Research, Education and Clinical Center US Department of Veterans Affairs Aurora, CO United States

EDITOR / REVIEWER

Tiffany Leung, Gunther Eysenbach