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eHealth-Anwendungen zur Förderung körperlicher Aktivität nach viszeralen Operationen

Eine systematische Übersichtsarbeit

eHealth applications for promotion of physical activity after visceral surgery

A systematic review

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best practice onkologie Aims and scope

Zusammenfassung

Hintergrund

eHealth-Anwendungen können die Frühmobilisation und körperliche Aktivität (kA) nach Operationen unterstützen. Dieses systematische Review soll einen Überblick über eHealth-Dienste zur Verbesserung oder Erfassung von kA nach viszeralchirurgischen Eingriffen geben.

Methoden

Zwei elektronische Datenbanken (MEDLINE PubMed und Web of Science) wurden systematisch durchsucht (November 2023). Artikel wurden als geeignet betrachtet, wenn es sich um kontrollierte Studien handelte, die digitale Geräte zur Förderung der kA nach viszeralchirurgischen Eingriffen beschrieben. Zur Bestimmung der methodischen Qualität der Studien wurde das Cochrane Risk of Bias (RoB-2) Tool verwendet.

Ergebnisse

Neun randomisierte kontrollierte Studien wurden eingeschlossen. Die Studien unterschieden sich hinsichtlich der Interventionen, der chirurgischen Indikationen und der Bewertungsvariablen. Das Biasrisiko der einzelnen Studien war moderat. Die sechs Studien, in denen Aktivitäts-Tracker (AT) verwendet wurden, erzielten überwiegend keine Verbesserungen der Schrittzahl nach der Operation. Die komplexeren Fitnessapplikationen konnten teilweise signifikante Vorteile gegenüber den Kontrollgruppen nachweisen. Ebenso zeigte ein heimbasiertes Onlinetraining eine signifikante Steigerung der funktionellen Kapazität.

Schlussfolgerungen

Alleiniges AT zeigt bisher keine klinisch relevanten Effekte. Im Gegensatz dazu zeigten die komplexeren eHealth-Anwendungen Vorteile im Vergleich zur üblichen postoperativen Versorgung. Für evidenzbasierte Empfehlungen für eHealth-Dienste in Verbindung mit Viszeralchirurgie sind weitere hochwertige Studien erforderlich.

Abstract

Background

eHealth applications can support early mobilization and physical activity (PA) after surgery. This systematic review provides an overview of eHealth services to enhance or record PA after visceral surgery interventions.

Methods

Two electronic databases (MEDLINE PubMed and Web of Science) were systematically searched (November 2023). Articles were considered eligible if they were controlled trials and described digital devices used to promote PA after visceral surgery. The Cochrane risk of bias (RoB-2) tool was used to determine the methodological quality of studies.

Results

A total of nine randomized controlled studies (RCT) were included in this systematic review. The studies differed with respect to the interventions, surgical indications and evaluation variables. The risk of bias of the individual studies was moderate. The six studies using activity trackers (AT) predominantly showed insignificant improvements in the postoperative step count. The more complex fitness applications could partially reveal significant advantages compared to the control groups and the home-based online training also showed a significant increase in functional capacity.

Conclusion

Activity tracking alone has so far failed to show clinically relevant effects. In contrast, the more complex eHealth applications revealed advantages compared to usual postoperative care. More high-quality studies are needed for evidence-based recommendations for eHealth services in conjunction with visceral surgery.

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  1. Institut für Sportmedizin und Prävention, Universität Leipzig, Rosa-Luxemburg-Str. 20–30, 04103, Leipzig, Deutschland

    Rebecca Dederichs, Johannes Voß &  Roberto Falz

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  1. Rebecca Dederichs
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  2. Johannes Voß
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Correspondence to Roberto Falz.

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R. Dederichs, J. Voß und R. Falz geben an, dass kein Interessenkonflikt besteht.

Alle in dieser Studie beschriebenen Verfahren wurden in Übereinstimmung mit den Prinzipien der Deklaration von Helsinki durchgeführt.

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Dieser Beitrag erschien zuerst in Chirurgie (2024) https://doi.org/10.1007/s00104-024-02060-7

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Dederichs, R., Voß, J. & Falz, R. eHealth-Anwendungen zur Förderung körperlicher Aktivität nach viszeralen Operationen. best practice onkologie 19, 238–247 (2024). https://doi.org/10.1007/s11654-024-00581-5

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