title: Is preoperative physical activity related to post-surgery recovery? A cohort study of patients with breast cancer.
abstract: OBJECTIVE
  The aim of our study is to assess the association between preoperative level of activity and recovery after breast cancer surgery measured as hospital stay, length of sick leave and self-assessed physical and mental recovery.
  
  
  METHODS
  A prospective cohort study.
  
  
  METHODS
  Patients included were those scheduled to undergo breast cancer surgery, between February and November 2013, at two participating hospitals in the Western Region of Sweden.
  
  
  METHODS
  Patients planned for breast cancer surgery filled out a questionnaire before, as well as at 3 and 6 weeks after the operation. The preoperative level of activity was self-assessed and categorised into four categories by the participants using the 4-level Saltin-Grimby Physical Activity Level Scale (SGPALS).
  
  
  METHODS
  Our main outcome was postoperative recovery measured as length of sick leave, in-hospital stay and self-assessed physical and mental recovery.
  
  
  RESULTS
  220 patients were included. Preoperatively, 14% (31/220) of participants assessed themselves to be physically inactive, 61% (135/220) to exert some light physical activity (PA) and 20% (43/220) to be more active (level 3+4). Patients operated with mastectomy versus partial mastectomy and axillary lymph node dissection versus sentinel node biopsy were less likely to have a short hospital stay, relative risk (RR) 0.88 (0.78 to 1.00) and 0.82 (0.70 to 0.96). More active participants (level 3 or 4) had an 85% increased chance of feeling physically recovered at 3 weeks after the operation, RR 1.85 (1.20 to 2.85). No difference was seen after 6 weeks.
  
  
  CONCLUSIONS
  The above study shows that a higher preoperative level of PA is associated with a faster physical recovery as reported by the patients 3 weeks post breast cancer surgery. After 6 weeks, most patients felt physically recovered, diminishing the association above. No difference was seen in length of sick leave or self-assessed mental recovery between inactive or more active patients.
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG-Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
authors.forename: Hanna
authors.initials: H
authors.lastname: Nilsson
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG-Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Angerås
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG-Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
authors.forename: David
authors.initials: D
authors.lastname: Bock
authors.affiliation: Swedish School of Sport and Health Sciences and Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Börjesson
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG-Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
authors.forename: Aron
authors.initials: A
authors.lastname: Onerup
authors.affiliation: Department of Gastrosurgical Research and Education, Gothenburg, Sweden.
authors.forename: Monika
authors.initials: M
authors.lastname: Fagevik Olsen
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG-Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden School of Business, Economics and IT, University West, Göteborg, Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Gellerstedt
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG-Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Haglind
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG-Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Angenete
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000601:surgery*; D003289:Convalescence; D015444:Exercise; D005260:Female; D006304:Health Status; D006801:Humans; D007902:Length of Stay; D008197:Lymph Node Excision; D008297:Male; D008408:Mastectomy; D008875:Middle Aged; D011184:Postoperative Period; D011300:Preoperative Care; D011446:Prospective Studies; D011788:Quality of Life; D018582:Sick Leave; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: PUBLIC HEALTH; REHABILITATION MEDICINE; SPORTS MEDICINE