Abstract：
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.
Prospective observational study.
Postoperative setting.
Patients undergoing mini-invasive lung surgery.
Measurement of postoperative mobility during the first five postoperative days using an accelerometer (ActiGraph GT3X).
The primary outcome was the number of daily steps. Secondary outcomes included physical activity 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.
Sixty patients were included in the study, of whom 56 provided at least one day of valid accelerometry 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 = 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.
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.
Prospective observational study.
Postoperative setting.
Patients undergoing mini-invasive lung surgery.
Measurement of postoperative mobility during the first five postoperative days using an accelerometer (ActiGraph GT3X).
The primary outcome was the number of daily steps. Secondary outcomes included physical activity 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.
Sixty patients were included in the study, of whom 56 provided at least one day of valid accelerometry 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 = 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.
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.
摘要：
目的：术后物理治疗和早期活动是促进术后恢复的主要因素。与可以监控的有监督的物理治疗相反，自我动员是不容易量化的，到目前为止主要通过患者自动报告进行估计。本研究旨在对术后活动度进行全面客观的评价。
方法：前瞻性观察性研究。
方法：术后设置。
方法：接受微创肺手术的患者。
方法：使用加速度计（ActiGraphGT3X）测量术后前五天的术后活动度。
方法：主要结果是每日步数。次要结果包括体力活动持续时间和强度，久坐的时间，久坐时间内的休息次数，久坐的模式，物理治疗师的日常评估，术后并发症,以及佩戴加速度计的可接受性。
结果：60例患者被纳入研究，其中56人提供了至少一天的有效加速度测量数据。在前四个POD中，关于每日步数或平均步频没有显着变化。一分钟的节奏高峰，总活动计数，光强度体力活动的持续时间随时间增加（分别为p=0.032，p=0.001和p=0.001）。久坐模式随着时间的推移发生了有利的变化，随着长时间久坐不动发作的减少(≥连续60分钟)(p<0.001)，和较短的回合增加（<10分钟）（p=0.001）。当针对手术发生的一周中的某一天调整分析时,观察到类似的结果。佩戴加速度计的中位数可接受性非常好（10点Likert量表的中位数为10[9-10]）。3例患者出现严重并发症。
结论：我们的研究结果表明，每日步数可能不是胸部手术后早期活动的唯一相关指标，并且加速度测量适用于随访患者术后早期活动。
方法：前瞻性观察性研究。
方法：术后设置。
方法：接受微创肺手术的患者。
方法：使用加速度计（ActiGraphGT3X）测量术后前五天的术后活动度。
方法：主要结果是每日步数。次要结果包括体力活动持续时间和强度，久坐的时间，久坐时间内的休息次数，久坐的模式，物理治疗师的日常评估，术后并发症,以及佩戴加速度计的可接受性。
结果：60例患者被纳入研究，其中56人提供了至少一天的有效加速度测量数据。在前四个POD中，关于每日步数或平均步频没有显着变化。一分钟的节奏高峰，总活动计数，光强度体力活动的持续时间随时间增加（分别为p=0.032，p=0.001和p=0.001）。久坐模式随着时间的推移发生了有利的变化，随着长时间久坐不动发作的减少(≥连续60分钟)(p<0.001)，和较短的回合增加（<10分钟）（p=0.001）。当针对手术发生的一周中的某一天调整分析时,观察到类似的结果。佩戴加速度计的中位数可接受性非常好（10点Likert量表的中位数为10[9-10]）。3例患者出现严重并发症。
结论：我们的研究结果表明，每日步数可能不是胸部手术后早期活动的唯一相关指标，并且加速度测量适用于随访患者术后早期活动。
