Wearable activity trackers and mobilization after major head and neck cancer surgery: You can't improve what you don't measure

Twomey, Rosie; Culos‐Reed, S. Nicole; Daun, Julia T.; Ferber, Reed; Dort, Joseph C.

doi:10.1016/j.ijsu.2020.10.032

Cited by 9 publications

(9 citation statements)

References 44 publications

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“…24 Pedometers can be used to monitor mobility and detect patients at risk for poor surgical outcomes early. 25 The study results reveal the importance of monitoring postoperative physical activity, but the postoperative step count in lung resections may be lower than in other surgical patients.…”

Section: Discussionmentioning

confidence: 80%

The Effect of Postoperative Mobilization with a Pedometer on Pulmonary Functions and Length of Postoperative Hospital Stay in Patients Undergoing Lung Resection: Cross-Sectional Study

Özkan¹,

Işıklı²,

Ünver³

et al. 2022

Turkiye Klinikleri Arch Lung

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ABS TRACT Objective: Mobilization takes an important place in providing postoperative pulmonary rehabilitation and is accepted as an effective factor in accelerating the recovery process and improving physical and mental health. This study aims to determine the effect of postoperative mobilization with a pedometer on pulmonary functions and length of postoperative hospital stay in patients undergoing lung resection. Material and Methods: This descriptive and cross-sectional study was conducted with the participation of 52 patients in a thoracic surgery clinic of a university hospital . The "patient identification form" and the "patient results evaluation form" were used to collect the data. Data were analyzed using IBM SPSS Statistics 22.0. Shapiro-Wilk test was used to test the compatibility of the data to normal distribution. The Spearman correlation analysis was used in analyzing the data. Result: It was revealed that the total step count and walking distance did not affect the postoperative forced expiratory volume in 1 second (FEV 1 ), forced vital capacity (FVC), and FEV 1 /FVC values (p>0.05). A weak negative correlation was determined between total step count and the length of postoperative hospital stay (p<0.05). It was found that 84.6% of the patients were satisfied/very satisfied with the use of a pedometer. Conclusion: The study demonstrated that the increase in the step count was not effective on pulmonary functions in the early period but shortened the length of postoperative hospital stay. We recommend the use of a pedometer after lung resections since it standardizes the mobilization measurement, promotes mobilization, and shortens the length of hospital stay owing to its contributions to pulmonary physiotherapy.

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Section: Discussionmentioning

confidence: 80%

The Effect of Postoperative Mobilization with a Pedometer on Pulmonary Functions and Length of Postoperative Hospital Stay in Patients Undergoing Lung Resection: Cross-Sectional Study

Özkan¹,

Işıklı²,

Ünver³

et al. 2022

Turkiye Klinikleri Arch Lung

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“…In the CHERP and many other enhanced recovery pathways for HNC surgery, mobilization has only been evaluated as the interval of days between surgery and mobilization, with variable definitions of what counts as mobilization [28]. The need for consistent charting places an undue burden on the healthcare team [29], and although this metric indicates how quickly a person begins to mobilize after surgery, it provides no information on how much. Avoiding bed rest, preventing functional decline and progressing towards preoperative activity levels helps patients meet discharge criteria earlier and sets the stage for a seamless transition to recovery at home.…”

Section: Discussionmentioning

confidence: 99%

“…An objective measure of mobilization would improve understanding of the dose-response relationship: the quantity of mobilization (e.g., number of daily step counts) that is safe and associated with improved patient outcomes [30]. Wearable technology can provide continuous feedback on activity across the hospital stay, which can be used by patients, the clinical team, and in prospective trials involving mobilization interventions [29].…”

Section: Discussionmentioning

confidence: 99%

Impact of Early Mobilization on Recovery after Major Head and Neck Surgery with Free Flap Reconstruction

Twomey

Matthews

Nakoneshny

et al. 2021

Cancers

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Surgery with free flap reconstruction is a standard treatment for head and neck cancer (HNC). Because of the complexity of HNC surgery, recovery can be challenging, and complications are common. One of the foundations of enhanced recovery after surgery (ERAS) is early postoperative mobilization. The ERAS guidelines for HNC surgery with free flap reconstruction recommend mobilization within 24 h. This is based mainly on evidence from other surgical disciplines, and the extent to which mobilization within 24 h improves recovery after HNC surgery has not been explored. This retrospective analysis included 445 patients from the Calgary Head and Neck Enhanced Recovery Program. Mobilization after 24 h was associated with more complications of any type (OR = 1.73, 95% CI [confidence interval] = 1.16–2.57) and more major complications (OR = 1.76; 95% CI = 1.00–3.16). When accounting for patient and clinical factors, mobilization after 48 h was a significant predictor of major complications (OR = 2.61; 95% CI = 1.10–6.21) and prolonged length of stay (>10 days; OR = 2.85, 95% CI = 1.41–5.76). This comprehensive analysis of the impact of early mobilization on postoperative complications and length of stay in a large HNC cohort provides novel evidence supporting adherence to the ERAS early mobilization recommendations. Early mobilization should be a priority for patients undergoing HNC surgery with free flap reconstruction.

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“…Patients were encouraged to walk before surgery and be prepared for early mobilization after surgery, and a pedometer was incorporated from the beginning of hospitalization [22]. We have previously highlighted that providing patients with continuous monitoring of steps is an important avenue for future research on improving outcomes after HNC surgery [33].…”

Section: Discussionmentioning

confidence: 99%

From Pathways to Practice: Impact of Implementing Mobilization Recommendations in Head and Neck Cancer Surgery with Free Flap Reconstruction

Twomey

Matthews

Nakoneshny

et al. 2021

Cancers

Self Cite

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One of the foundational elements of enhanced recovery after surgery (ERAS) guidelines is early postoperative mobilization. For patients undergoing head and neck cancer (HNC) surgery with free flap reconstruction, the ERAS guideline recommends patients be mobilized within 24 h postoperatively. The objective of this study was to evaluate compliance with the ERAS recommendation for early postoperative mobilization in 445 consecutive patients who underwent HNC surgery in the Calgary Head and Neck Enhanced Recovery Program. This retrospective analysis found that recommendation compliance increased by 10% despite a more aggressive target for mobilization (from 48 to 24 h). This resulted in a decrease in postoperative mobilization time and a stark increase in the proportion of patients mobilized within 24 h (from 10% to 64%). There was a significant relationship between compliance with recommended care and time to postoperative mobilization (Spearman’s rho = −0.80; p < 0.001). Hospital length of stay was reduced by a median of 2 days, from 12 (1QR = 9–16) to 10 (1QR = 8–14) days (z = 3.82; p < 0.001) in patients who received guideline-concordant care. Engaging the clinical team and changing the order set to support clinical decision-making resulted in increased adherence to guideline-recommended care for patients undergoing major HNC surgery with free flap reconstruction.

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Wearable activity trackers and mobilization after major head and neck cancer surgery: You can't improve what you don't measure

Abstract: Wearable activity trackers and mobilization after major head and neck cancer surgery: you can't improve what you don't measure

Cited by 9 publications

References 44 publications

The Effect of Postoperative Mobilization with a Pedometer on Pulmonary Functions and Length of Postoperative Hospital Stay in Patients Undergoing Lung Resection: Cross-Sectional Study

The Effect of Postoperative Mobilization with a Pedometer on Pulmonary Functions and Length of Postoperative Hospital Stay in Patients Undergoing Lung Resection: Cross-Sectional Study

Impact of Early Mobilization on Recovery after Major Head and Neck Surgery with Free Flap Reconstruction

From Pathways to Practice: Impact of Implementing Mobilization Recommendations in Head and Neck Cancer Surgery with Free Flap Reconstruction

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