Assessing physical activity levels in people living with a stoma

Lowe, Bethany Grace; Alsaleh, Eman; Blake, Holly

doi:10.7748/ns.2019.e11278

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…Thirty-seven percent of rectal cancer survivors with a stoma met or exceeded recommendations in a large US survey [30] and so did less than 20% of stoma patients in a small British survey of patients attending a support group [31]. Both numbers are markedly lower than the 51% meeting guideline recommendations in our sample.…”

Section: Discussioncontrasting

confidence: 62%

Physical activity after colorectal cancer surgery—a cross sectional study of patients with a long-term stoma

Krogsgaard

Andersen

Danielsen

et al. 2021

Support Care Cancer

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Physical activity is recommended to cancer survivors by the World Health Organisation (WHO) and is associated with improved survival after colorectal cancer. It remains unclear whether having a stoma is a barrier for an active lifestyle. We examined the level of physical activity and explored factors impacting physical activity in survivors with a stoma. MethodsA total of 1265 (65%) patients in the Danish Stoma Database completed a multidimensional survey.Physical activity of moderate-and vigorous-intensity was assessed using two validated questions. Based on WHO guidelines, physical activity was categorised into 'Meeting' or 'Not Meeting' recommendations.Multivariate regression analysis, adjusting for potential confounders, provided odds ratio (OR) and 95% confidence intervals (CI) for factors' association with 'Not Meeting' guideline recommendations. ResultsIn total, 571 patients with colorectal cancer reported on physical activity at a median of 4.3 years (interquartile range 3.1-5.8) after stoma surgery. Two hundred ninety-three patients (51%) were 'Meeting recommendations' and 63% of them were 'Highly active'. Two hundred seventy-eight were 'Not meeting' recommendations (49%).Of the factors analysed, patients without support garment were more likely (OR 1.72 [95% CI 1.16; 2.54] not to meet guideline recommendations. We found no association between stoma type, surgical procedure, parastomal bulging and 'problematic stoma' and level of physical activity, respectively. ConclusionIn this large sample of survivors with a stoma half of patients met or exceeded guideline recommendations.Of patients not meeting recommendations some could potentially meet the recommendations by modest increases in either moderate or vigorous activity.

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Section: Discussioncontrasting

confidence: 62%

Physical activity after colorectal cancer surgery—a cross sectional study of patients with a long-term stoma

Krogsgaard

Andersen

Danielsen

et al. 2021

Support Care Cancer

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“…These HADS scores are within the normal range (0–7) for the HADS scoring criteria, and thus did not meet the clinical threshold for major depressive disorder [ 17 ]. Of the included studies, four used the PHQ-9 as a measure of depressive symptoms, however none reported raw PHQ-9 scores, merely rates of depressive symptoms within the study population [ 45 , 62 , 69 , 82 ]. Of the four included studies that used the BDI, all reported mean scores [ 25 , 42 , 49 , 50 ].…”

Section: Resultsmentioning

confidence: 99%

Depression after stoma surgery: a systematic review and meta-analysis

Kovoor,

Jacobsen,

Stretton

et al. 2023

BMC Psychiatry

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Background Depression is the leading cause of global disability and can develop following the change in body image and functional capacity associated with stoma surgery. However, reported prevalence across the literature is unknown. Accordingly, we performed a systematic review and meta-analysis aiming to characterise depressive symptoms after stoma surgery and potential predictive factors. Methods PubMed/MEDLINE, Embase, CINAHL and Cochrane Library were searched from respective database inception to 6 March 2023 for studies reporting rates of depressive symptoms after stoma surgery. Risk of bias was assessed using the Downs and Black checklist for non-randomised studies of interventions (NRSIs), and Cochrane RoB2 tool for randomised controlled trials (RCTs). Meta-analysis incorporated meta-regressions and a random-effects model. Registration: PROSPERO, CRD42021262345. Results From 5,742 records, 68 studies were included. According to Downs and Black checklist, the 65 NRSIs were of low to moderate methodological quality. According to Cochrane RoB2, the three RCTs ranged from low risk of bias to some concerns of bias. Thirty-eight studies reported rates of depressive symptoms after stoma surgery as a proportion of the respective study populations, and from these, the median rate across all timepoints was 42.9% 42.9% (IQR: 24.2–58.9%). Pooled scores for respective validated depression measures (Hospital Anxiety and Depression Score (HADS), Beck Depression Inventory (BDI), and Patient Health Questionnaire-9 (PHQ-9)) across studies reporting those scores were below clinical thresholds for major depressive disorder according to severity criteria of the respective scores. In the three studies that used the HADS to compare non-stoma versus stoma surgical populations, depressive symptoms were 58% less frequent in non-stoma populations. Region (Asia–Pacific; Europe; Middle East/Africa; North America) was significantly associated with postoperative depressive symptoms (p = 0.002), whereas age (p = 0.592) and sex (p = 0.069) were not. Conclusions Depressive symptoms occur in almost half of stoma surgery patients, which is higher than the general population, and many inflammatory bowel disease and colorectal cancer populations outlined in the literature. However, validated measures suggest this is mostly at a level of clinical severity below major depressive disorder. Stoma patient outcomes and postoperative psychosocial adjustment may be enhanced by increased psychological evaluation and care in the perioperative period.

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“…An intervention that involves appropriate physical activity for rehabilitation for physical recovery is important after an illness or surgery. Providing exercise is secure during and after chemotherapy for cancer and leads to enhancements in physical functioning, fatigue, and quality of life [ 11 , 12 ]. So, individuals who have ostomies need specific care during the recovery and rehabilitation phases to improve their physical activity and maintain their physical well-being and quality of life [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of the Specific Mobility Exercises on Pain Intensity and Quality of Life Among Stoma Patients: A Quasi-experimental Study

Abdul Khadar,

Ramalingam

2024

Cureus

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Background: An intestinal stoma is a surgically created artificial opening in the abdominal wall that helps the large or small intestine end to divert the faecal matter for stoma patients with an underlying condition of inflammatory bowel disease and colorectal cancer. When a stoma is formed following surgery, one of the difficulties stoma patients confront has been identified as prolonged immobilization, which can eventually result in muscle inactivity that results due to their illness. Patients with stoma often experience an increase in pain and a decrease in quality of life. Patients can be mobilized and their muscles can be activated with the help of an early intervention called specific mobility exercises. Aim: The present study aimed to explore the specific mobility exercises that reduce pain and improve quality of life among stoma patients. Methodology: This quasi-experimental study involved 21 patients who underwent stoma surgery and were selected according to the inclusion and exclusion criteria. The experimental procedures were explained to all the patients and their written informed consent was obtained. The patients performed specific mobility exercises for 30 minutes per day. Treatment was given for four weeks every day after three to four days of stoma surgery. The patient's pain and quality of life were assessed using the Numerical Pain Rating Scale and the Stoma-Quality of Life (QoL) Questionnaire and pre-test and post-test values were recorded before and after the exercises. The data were tabulated and evaluated. Results: The findings suggest that specific mobility exercises following four weeks of intervention have a significant effect (p< 0.001) in reducing pain except in young adult stoma patients as they were found to be anxious and depressed, which was reflected in the findings as not statistically significant for pain on the NPRS (t(1) = 7, p > 0.001). However, it has been demonstrated that these specific mobility exercises have a significant effect (p< 0.001) in improving the quality of life among all stoma patients. Conclusion: The study evidenced that four weeks of specific mobility exercises in line with general medical treatment showed a significant reduction in pain and an improvement in quality of life among stoma patients. However, it should be noted that in the study, the majority of stoma patients were male and there were only a few patients with inflammatory bowel disease, which can limit the study findings. Future studies have to focus on equally distributing gender and conditions by emphasizing the importance of randomizing patients into the experimental and control groups and involving a combination of other exercises in rehabilitation for patients following stoma surgery.

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Assessing physical activity levels in people living with a stoma

Cited by 4 publications

References 23 publications

Physical activity after colorectal cancer surgery—a cross sectional study of patients with a long-term stoma

Physical activity after colorectal cancer surgery—a cross sectional study of patients with a long-term stoma

Depression after stoma surgery: a systematic review and meta-analysis

Effectiveness of the Specific Mobility Exercises on Pain Intensity and Quality of Life Among Stoma Patients: A Quasi-experimental Study

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