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Article Dans Une Revue Journal of Clinical Anesthesia Année : 2023

Comprehensive assessment of postoperative mobility during the first days after mini-invasive lung surgery: A prospective observational study

Résumé

Study objective: Postoperative physical therapy and early mobilization are major elements for enhanced recovery after surgery. In contrast with supervised physical therapy sessions that can be monitored, self-mobilization is not easily quantifiable and has so far been estimated mainly through patient auto-reports. This study aimed to perform a comprehensive and objective evaluation of postoperative mobility. Design: Prospective observational study. Setting: Postoperative setting. Patients: Patients undergoing mini-invasive lung surgery. Interventions: Measurement of postoperative mobility during the first five postoperative days using an acceler- ometer (ActiGraph GT3X). Measurements: The primary outcome was the number of daily steps. Secondary outcomes included physical ac- tivity duration and intensity, sedentary time, number of breaks in sedentary time, sedentary patterns, daily evaluation by physiotherapists, postoperative complications, and acceptability of wearing the accelerometer. Main results: Sixty patients were included in the study, of whom 56 provided at least one day of valid accel- erometry data. There was no significant change during the first four PODs concerning the number of daily steps nor the mean cadence. One-minute cadence peak, total activity counts, and duration of light-intensity physical activity increased over time (p = 0.032, p = 0.001 and p = 0.001, respectively). Sedentary patterns changed favorably over time, with a decrease in prolonged sedentary bouts (≥ 60 consecutive min) (p < 0.001), and an increase in shorter bouts (< 10 min) (p ¼ 0.001). Similar results were observed when analysis was adjusted for the day of the week when the surgery took place. The median acceptability of wearing the accelerometer was excellent (median 10 [9-10] on a 10-point Likert scale). Three patients had major complications. Conclusions: Our findings suggest that daily steps may not be the only relevant indicator of early mobility following thoracic surgery and that accelerometry is suitable to follow patients’ early postoperative activity.
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hal-04093919 , version 1 (10-05-2023)

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Michaël Finet, Alice Bellicha, Edouard Sage, Matthieu Glorion, Titouan Kennel, et al.. Comprehensive assessment of postoperative mobility during the first days after mini-invasive lung surgery: A prospective observational study. Journal of Clinical Anesthesia, 2023, 86, pp.111048. ⟨10.1016/j.jclinane.2022.111048⟩. ⟨hal-04093919⟩
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