Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
J Gastrointest Surg. 2019 Jun;23(6):1218-1226. doi: 10.1007/s11605-018-3998-0. Epub 2018 Oct 8.
Early mobilization is one essential item within the enhanced recovery after surgery (ERAS) concept, but lacks solid evidence and a standardized assessment. The aim was to monitor and increase the postoperative mobilization of patients after major visceral surgery by providing a continuous step count feedback using activity tracking wristbands.
The study was designed as a randomized controlled single-center trial (NCT02834338) with two arms (open and laparoscopic surgery). Participants were randomized to either receive feedback of their step counts using an activity tracker wristband or not. The primary study endpoint was the mean step count during the first 5 postoperative days (PODs).
A total of 132 patients were randomized. After laparoscopic operations, the average step count during PODs 1-5 was significantly increased by the feedback compared with the control group (P < 0.001); the cumulative step count (9867 versus 6103, P = 0.037) and activity time were also significantly increased. These results could not be confirmed in the open surgery arm. Possible reasons were a higher age and significantly more comorbidities in the open intervention group. Patients who achieved more than the median cumulative step count had a significantly shorter hospital stay and lower morbidity in both arms. The average step count also correlated with the length of hospital stay (R = - 0.341, P < 0.001).
This study is the first randomized controlled trial investigating the use and feasibility of activity tracking to monitor and enhance postoperative mobilization in abdominal surgery. Our results demonstrate that activity tracking can enhance perioperative mobilization after laparoscopic surgery.
ClinicalTrials.gov: NCT02834338.
早期活动是加速康复外科（ERAS）概念中的一个重要内容，但缺乏确凿的证据和标准化评估。本研究旨在通过使用活动追踪腕带提供连续的步数反馈，来监测和增加主要内脏手术后患者的术后活动量。
本研究设计为一项随机对照单中心试验（NCT02834338），分为两组（开放手术和腹腔镜手术）。参与者被随机分配到接受或不接受活动追踪腕带的步数反馈。主要研究终点是术后第 1 至 5 天（POD）的平均步数。
共纳入 132 例患者。与对照组相比，腹腔镜手术后第 1 至 5 天的平均步数在接受反馈组显著增加（P<0.001）；累计步数（9867 与 6103，P=0.037）和活动时间也显著增加。然而，这些结果在开放手术组并未得到证实。可能的原因是开放干预组的患者年龄较大，合并症更多。在两组中，达到中位数累计步数以上的患者的住院时间明显缩短，发病率降低。平均步数也与住院时间呈负相关（R=-0.341，P<0.001）。
本研究是首次随机对照试验，探讨了使用活动追踪来监测和增强腹部手术后的术后活动的可行性。我们的结果表明，活动追踪可以增强腹腔镜手术后的围手术期活动。
ClinicalTrials.gov：NCT02834338。
