Use of Activity Tracking in Major Visceral Surgery—the Enhanced Perioperative Mobilization Trial: a Randomized Controlled Trial
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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.
KeywordsActivity tracking Postoperative recovery ERAS Fast-track surgery Randomized controlled trial
S.W. designed the study, collected and analyzed the data, and drafted the manuscript. T.M., S.L., B.M., A.B., and A.W. assisted with the data collection. J.W., N.R., and M.D. worked on the study design and the final manuscript. D.S. assisted with the study design. T.W. designed the study and finalized the manuscript.
Compliance with Ethical Standards
All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. This study was registered on ClinicalTrials.gov (NCT02834338) and approved by the local Ethics Committee of the TU Dresden (decision number EK226062016). This article does not contain any studies with animals performed by any of the authors.
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