Resumption of daily physical activity after day-case laparoscopic cholecystectomy.
BACKGROUND
Laparoscopic cholecystectomy has been proven to be safe and feasible as a day-case procedure. Few studies investigated postoperative activity resumption. The goal of this study was to objectively assess daily physical activity after day-case laparoscopic cholecystectomy and evaluate the effect of encouragement of patients.


METHODS
This prospective controlled study measured daily physical activity in an unselected patient population undergoing day-case laparoscopic cholecystectomy by using an accelerometer for 1 week before surgery to 1 week after. First, a control group received standard care. Subsequently, an intervention group was encouraged to swift resumption of daily physical activity by means of standardized advice combined with individualized activity goals. Outcome measures were activity scores, visual analogue scores (VAS) for pain and nausea and subjective factors limiting activity.


RESULTS
Sixty-four patients completed the study (n = 28 in the control group, n = 36 in the intervention group). In the control group, 36% of the patients reached their preoperative activity level after 1 week, as compared to 50% in the intervention group (p = 0.19). Resumption of daily physical activity during the first postoperative week in the intervention group was not significantly different from the control group [repeated measures analysis of variance (MANOVA), p = 0.05]. However, in contrast with men, women in the intervention group did show a faster recovery of daily physical activity as compared to the control group (MANOVA, p = 0.02). Although there was no significant difference in postoperative VAS scores for pain and nausea between both groups, patients in the intervention group experienced pain less often as a limiting factor (p = 0.006).


CONCLUSIONS
Recovery of daily physical activity exceeded 1 week in most patients undergoing day-case laparoscopic cholecystectomy. The use of an accelerometer and standardized encouragement accelerated recovery in women.
Wasowicz-Kemps
Daria K
DK
Department of Surgery, St Antonius Hospital, Koekoekslaan 1, PO Box 2500, Nieuwegein, 3430 EM, The Netherlands. d.wasowicz@antonius.net
Slootmaker
Sander M
SM
Kemps
Hareld M C
HM
Borel-Rinkes
Inne H M
IH
Biesma
Douwe H
DH
van Ramshorst
Bert
B
D000203:Activities of Daily Living; D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000534:rehabilitation*; D000700:Analgesics / Q000627:therapeutic use; D017081:Cholecystectomy, Laparoscopic / Q000534:rehabilitation*; D004434:Early Ambulation; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D055617:Micro-Electrical-Mechanical Systems / Q000295:instrumentation; D008875:Middle Aged; D009042:Motivation; D009043:Motor Activity; D017294:Ondansetron / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy / Q000453:epidemiology; D011446:Prospective Studies; D020127:Recovery of Function; D016896:Treatment Outcome
D000700:Analgesics; D017294:Ondansetron