title: Physical activity before radical prostatectomy reduces sick leave after surgery - results from a prospective, non-randomized controlled clinical trial (LAPPRO).
abstract: BACKGROUND
  Studies have reported that early physical rehabilitation after surgical procedures is associated with improved outcome measured as shorter hospital stay and enhanced recovery. The aim of this study was to explore the relationship between the preoperative physical activity level and subsequent postoperative complications, sick-leave and hospital stay after radical prostatectomy for prostate cancer in the setting of the LAPPRO trial (LAParoscopic Prostatectomy Robot Open).
  
  
  METHODS
  LAPPRO is a prospective controlled trial, comparing robot-assisted laparoscopic and open surgery for localized prostate cancer between 2008 and 2011. 1569 patients aged 64 or less with an occupation were included in this sub-study. The Gleason score was <7 in 52 % of the patients. Demographics and the level of self-assessed preoperative physical activity, length of hospital stay, complications, quality of life, recovery and sick-leave were extracted from clinical record forms and questionnaires. Multivariable logistic regression, with log-link and logit-link functions, was used to adjust for potential confounding variables.
  
  
  RESULTS
  The patients were divided into four groups based on their level of activity. As the group with lowest engagement of physical activity was found to be significantly different in base line characteristics from the other groups they were excluded from further analysis. Among patients that were physically active preoperativelly (n = 1467) there was no significant difference between the physical activity-groups regarding hospital stay, recovery or complications. However, in the group with the highest self-assessed level of physical activity, 5-7 times per week, 13 % required no sick leave, compared to 6.3 % in the group with a physical activity level of 1-2 times per week only (p < 0.0001).
  
  
  CONCLUSIONS
  In our study of med operated with radical prostatectomy, a high level of physical activity preoperatively was associated with reduced need for sick leave after radical prostatectomy compared to men with lower physical activity.
  
  
  BACKGROUND
  The trial is registered at the ISCRTN register. ISRCTN06393679 .
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG, Sahlgrenska University Hospital/Östra, SE-416 85, Gothenburg, Sweden. eva.angenete@vgregion.se.
authors.forename: E
authors.initials: E
authors.lastname: Angenete
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG, Sahlgrenska University Hospital/Östra, SE-416 85, Gothenburg, Sweden.
authors.forename: U
authors.initials: U
authors.lastname: Angerås
authors.affiliation: Swedish School of Sport and Health Sciences, Stockholm, Sweden.|Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Börjesson
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG, Sahlgrenska University Hospital/Östra, SE-416 85, Gothenburg, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Ekelund
authors.affiliation: University West, Trollhättan, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Gellerstedt
authors.affiliation: Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
authors.forename: T
authors.initials: T
authors.lastname: Thorsteinsdottir
authors.affiliation: Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.|Department of Oncology and Pathology, Division of Clinical Cancer Epidemiology, Karolinska Institutet, Solna, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Steineck
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG, Sahlgrenska University Hospital/Östra, SE-416 85, Gothenburg, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Haglind
mesh_terms: D000328:Adult; D015444:Exercise; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D018582:Sick Leave / Q000706:statistics & numerical data*
keywords: Physical fitness; Prostatectomy; Prostatic neoplasm