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The impact of physical activity on patient-reported outcomes following deep inferior epigastric perforator flap breast reconstruction
Although higher preoperative physical activity levels have been shown to be beneficial to postoperative recovery at large, their effect on patient-reported outcomes after deep inferior epigastric perforator (DIEP) flap breast reconstruction has yet to be investigated. This study aimed to correlate p...
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| Published in: | Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2024-10, Vol.97, p.6-12 |
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| container_title | Journal of plastic, reconstructive & aesthetic surgery |
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| creator | Kapila, Ayush K. Iyer, Hari Mohanna, Pari Mughal, Maleeha Hamdi, Moustapha Rose, Victoria |
| description | Although higher preoperative physical activity levels have been shown to be beneficial to postoperative recovery at large, their effect on patient-reported outcomes after deep inferior epigastric perforator (DIEP) flap breast reconstruction has yet to be investigated. This study aimed to correlate patient physical activity levels with patient-reported outcome measures.
A prospectively maintained database of patients who underwent DIEP flap breast reconstruction between July 2021 and June 2022 was analysed. Physical activity levels were assessed using the Global Physical Activity Questionnaire (GPAQ) and patient-reported outcomes were measured using the BREAST-Q questionnaire, both preoperatively and 1 year postoperatively. Patients were stratified into low (1000 METs) physical activity groups.
Of the 136 patients who underwent surgery, 51 completed both questionnaires, with 34 responses meeting completeness criteria for statistical analysis. The low-MET group (n = 19) and high-MET group (n = 15) were comparable in age and comorbidities. Postoperatively, the low-MET group exhibited a 54% increase in physical activity levels, whereas the high-MET group showed a 17% decrease (p |
| doi_str_mv | 10.1016/j.bjps.2024.07.050 |
| format | article |
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A prospectively maintained database of patients who underwent DIEP flap breast reconstruction between July 2021 and June 2022 was analysed. Physical activity levels were assessed using the Global Physical Activity Questionnaire (GPAQ) and patient-reported outcomes were measured using the BREAST-Q questionnaire, both preoperatively and 1 year postoperatively. Patients were stratified into low (<1000 METs) and high (>1000 METs) physical activity groups.
Of the 136 patients who underwent surgery, 51 completed both questionnaires, with 34 responses meeting completeness criteria for statistical analysis. The low-MET group (n = 19) and high-MET group (n = 15) were comparable in age and comorbidities. Postoperatively, the low-MET group exhibited a 54% increase in physical activity levels, whereas the high-MET group showed a 17% decrease (p < 0.01). The low-MET group experienced significant declines in psychosocial well-being (9.3%, p = 0.04) and sexual well-being (14%, p = 0.02), whereas the high-MET group did not show significant changes in these domains. Satisfaction with the unclothed abdomen increased significantly in the low-MET group (2.9 from 2, p = 0.001), while the high-MET group showed a nonsignificant decrease (3.2 from 2.9, p = 0.43). However, abdominal well-being significantly decreased in both groups, with a 56% decline in the high-MET group (p = 0.006) and a 51% decline in the low-MET group (p = 0.0002). The latter reflects the perceived difference between aesthetic appearance and well-being.
Patients with lower preoperative physical activity levels showed improved activity postsurgery, potentially due to motivational factors from the reconstructive process. Conversely, those with higher preoperative activity levels faced greater challenges in maintaining their activity levels postsurgery, potentially arising from disruptions in daily routines and donor site symptoms, indicating a need for targeted interventions to support this group. Concurrently, patients with higher baseline exercise levels did not show a decrease in psychosocial and sexual well-being, possibly reflecting a higher resilience to the operative process. These findings underscore the importance of integrating physical activity assessments into preoperative evaluations to inform patient-centred care and optimise recovery outcomes.</description><identifier>ISSN: 1748-6815</identifier><identifier>ISSN: 1878-0539</identifier><identifier>EISSN: 1878-0539</identifier><identifier>DOI: 10.1016/j.bjps.2024.07.050</identifier><identifier>PMID: 39121549</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Abdominal well-being ; Adult ; Breast Neoplasms - surgery ; Breast reconstruction ; Epigastric Arteries - transplantation ; Exercise ; Exercise levels ; Female ; Humans ; Mammaplasty - methods ; Middle Aged ; Patient Reported Outcome Measures ; Patient Satisfaction ; Patient-reported outcomes ; Perforator Flap - blood supply ; Physical activity ; Prospective Studies ; Quality of Life ; Surveys and Questionnaires</subject><ispartof>Journal of plastic, reconstructive & aesthetic surgery, 2024-10, Vol.97, p.6-12</ispartof><rights>2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons</rights><rights>Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c237t-db3a6a8efeee90d01003b1036f0f1ec90b85087fa41b58705269831c9dd39923</cites><orcidid>0000-0003-0166-9470 ; 0000-0001-7533-5540</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39121549$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kapila, Ayush K.</creatorcontrib><creatorcontrib>Iyer, Hari</creatorcontrib><creatorcontrib>Mohanna, Pari</creatorcontrib><creatorcontrib>Mughal, Maleeha</creatorcontrib><creatorcontrib>Hamdi, Moustapha</creatorcontrib><creatorcontrib>Rose, Victoria</creatorcontrib><title>The impact of physical activity on patient-reported outcomes following deep inferior epigastric perforator flap breast reconstruction</title><title>Journal of plastic, reconstructive & aesthetic surgery</title><addtitle>J Plast Reconstr Aesthet Surg</addtitle><description>Although higher preoperative physical activity levels have been shown to be beneficial to postoperative recovery at large, their effect on patient-reported outcomes after deep inferior epigastric perforator (DIEP) flap breast reconstruction has yet to be investigated. This study aimed to correlate patient physical activity levels with patient-reported outcome measures.
A prospectively maintained database of patients who underwent DIEP flap breast reconstruction between July 2021 and June 2022 was analysed. Physical activity levels were assessed using the Global Physical Activity Questionnaire (GPAQ) and patient-reported outcomes were measured using the BREAST-Q questionnaire, both preoperatively and 1 year postoperatively. Patients were stratified into low (<1000 METs) and high (>1000 METs) physical activity groups.
Of the 136 patients who underwent surgery, 51 completed both questionnaires, with 34 responses meeting completeness criteria for statistical analysis. The low-MET group (n = 19) and high-MET group (n = 15) were comparable in age and comorbidities. Postoperatively, the low-MET group exhibited a 54% increase in physical activity levels, whereas the high-MET group showed a 17% decrease (p < 0.01). The low-MET group experienced significant declines in psychosocial well-being (9.3%, p = 0.04) and sexual well-being (14%, p = 0.02), whereas the high-MET group did not show significant changes in these domains. Satisfaction with the unclothed abdomen increased significantly in the low-MET group (2.9 from 2, p = 0.001), while the high-MET group showed a nonsignificant decrease (3.2 from 2.9, p = 0.43). However, abdominal well-being significantly decreased in both groups, with a 56% decline in the high-MET group (p = 0.006) and a 51% decline in the low-MET group (p = 0.0002). The latter reflects the perceived difference between aesthetic appearance and well-being.
Patients with lower preoperative physical activity levels showed improved activity postsurgery, potentially due to motivational factors from the reconstructive process. Conversely, those with higher preoperative activity levels faced greater challenges in maintaining their activity levels postsurgery, potentially arising from disruptions in daily routines and donor site symptoms, indicating a need for targeted interventions to support this group. Concurrently, patients with higher baseline exercise levels did not show a decrease in psychosocial and sexual well-being, possibly reflecting a higher resilience to the operative process. These findings underscore the importance of integrating physical activity assessments into preoperative evaluations to inform patient-centred care and optimise recovery outcomes.</description><subject>Abdominal well-being</subject><subject>Adult</subject><subject>Breast Neoplasms - surgery</subject><subject>Breast reconstruction</subject><subject>Epigastric Arteries - transplantation</subject><subject>Exercise</subject><subject>Exercise levels</subject><subject>Female</subject><subject>Humans</subject><subject>Mammaplasty - methods</subject><subject>Middle Aged</subject><subject>Patient Reported Outcome Measures</subject><subject>Patient Satisfaction</subject><subject>Patient-reported outcomes</subject><subject>Perforator Flap - blood supply</subject><subject>Physical activity</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Surveys and Questionnaires</subject><issn>1748-6815</issn><issn>1878-0539</issn><issn>1878-0539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kM9u1DAQxi3UipaFF-CAfOSSMI7zx5a4oAoKUiUue7ccZ9x6lcTGdor2AXjverWlxx6s8cx8843mR8hHBjUD1n851OMhpLqBpq1hqKGDN-SaiUFU0HF5Uf5DK6pesO6KvEvpANBy1nZvyRWXrGFdK6_Jv_0DUrcEbTL1loaHY3JGz7Tk7tHlI_UrDTo7XHMVMfiYcaJ-y8YvmKj18-z_uvWeToiButVidD5SDO5epxydoQGj9VHnUrWzDnSMWDo0ovFrUWxlj1_fk0ur54QfnuOO7H9839_8rO5-3_66-XZXmYYPuZpGrnst0CKihAkYAB8Z8N6CZWgkjKIDMVjdsrETA3RNLwVnRk4Tl7LhO_L5bBui_7NhympxyeA86xX9lhSHwkVwWd6ONGepiT6liFaF6BYdj4qBOtFXB3Wir070FQyq0C9Dn579t3HB6WXkP-4i-HoWYDny0WFUyRS0BidXgGQ1efea_xOFfJnE</recordid><startdate>202410</startdate><enddate>202410</enddate><creator>Kapila, Ayush K.</creator><creator>Iyer, Hari</creator><creator>Mohanna, Pari</creator><creator>Mughal, Maleeha</creator><creator>Hamdi, Moustapha</creator><creator>Rose, Victoria</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0166-9470</orcidid><orcidid>https://orcid.org/0000-0001-7533-5540</orcidid></search><sort><creationdate>202410</creationdate><title>The impact of physical activity on patient-reported outcomes following deep inferior epigastric perforator flap breast reconstruction</title><author>Kapila, Ayush K. ; Iyer, Hari ; Mohanna, Pari ; Mughal, Maleeha ; Hamdi, Moustapha ; Rose, Victoria</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c237t-db3a6a8efeee90d01003b1036f0f1ec90b85087fa41b58705269831c9dd39923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abdominal well-being</topic><topic>Adult</topic><topic>Breast Neoplasms - surgery</topic><topic>Breast reconstruction</topic><topic>Epigastric Arteries - transplantation</topic><topic>Exercise</topic><topic>Exercise levels</topic><topic>Female</topic><topic>Humans</topic><topic>Mammaplasty - methods</topic><topic>Middle Aged</topic><topic>Patient Reported Outcome Measures</topic><topic>Patient Satisfaction</topic><topic>Patient-reported outcomes</topic><topic>Perforator Flap - blood supply</topic><topic>Physical activity</topic><topic>Prospective Studies</topic><topic>Quality of Life</topic><topic>Surveys and Questionnaires</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kapila, Ayush K.</creatorcontrib><creatorcontrib>Iyer, Hari</creatorcontrib><creatorcontrib>Mohanna, Pari</creatorcontrib><creatorcontrib>Mughal, Maleeha</creatorcontrib><creatorcontrib>Hamdi, Moustapha</creatorcontrib><creatorcontrib>Rose, Victoria</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kapila, Ayush K.</au><au>Iyer, Hari</au><au>Mohanna, Pari</au><au>Mughal, Maleeha</au><au>Hamdi, Moustapha</au><au>Rose, Victoria</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of physical activity on patient-reported outcomes following deep inferior epigastric perforator flap breast reconstruction</atitle><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle><addtitle>J Plast Reconstr Aesthet Surg</addtitle><date>2024-10</date><risdate>2024</risdate><volume>97</volume><spage>6</spage><epage>12</epage><pages>6-12</pages><issn>1748-6815</issn><issn>1878-0539</issn><eissn>1878-0539</eissn><abstract>Although higher preoperative physical activity levels have been shown to be beneficial to postoperative recovery at large, their effect on patient-reported outcomes after deep inferior epigastric perforator (DIEP) flap breast reconstruction has yet to be investigated. This study aimed to correlate patient physical activity levels with patient-reported outcome measures.
A prospectively maintained database of patients who underwent DIEP flap breast reconstruction between July 2021 and June 2022 was analysed. Physical activity levels were assessed using the Global Physical Activity Questionnaire (GPAQ) and patient-reported outcomes were measured using the BREAST-Q questionnaire, both preoperatively and 1 year postoperatively. Patients were stratified into low (<1000 METs) and high (>1000 METs) physical activity groups.
Of the 136 patients who underwent surgery, 51 completed both questionnaires, with 34 responses meeting completeness criteria for statistical analysis. The low-MET group (n = 19) and high-MET group (n = 15) were comparable in age and comorbidities. Postoperatively, the low-MET group exhibited a 54% increase in physical activity levels, whereas the high-MET group showed a 17% decrease (p < 0.01). The low-MET group experienced significant declines in psychosocial well-being (9.3%, p = 0.04) and sexual well-being (14%, p = 0.02), whereas the high-MET group did not show significant changes in these domains. Satisfaction with the unclothed abdomen increased significantly in the low-MET group (2.9 from 2, p = 0.001), while the high-MET group showed a nonsignificant decrease (3.2 from 2.9, p = 0.43). However, abdominal well-being significantly decreased in both groups, with a 56% decline in the high-MET group (p = 0.006) and a 51% decline in the low-MET group (p = 0.0002). The latter reflects the perceived difference between aesthetic appearance and well-being.
Patients with lower preoperative physical activity levels showed improved activity postsurgery, potentially due to motivational factors from the reconstructive process. Conversely, those with higher preoperative activity levels faced greater challenges in maintaining their activity levels postsurgery, potentially arising from disruptions in daily routines and donor site symptoms, indicating a need for targeted interventions to support this group. Concurrently, patients with higher baseline exercise levels did not show a decrease in psychosocial and sexual well-being, possibly reflecting a higher resilience to the operative process. These findings underscore the importance of integrating physical activity assessments into preoperative evaluations to inform patient-centred care and optimise recovery outcomes.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>39121549</pmid><doi>10.1016/j.bjps.2024.07.050</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-0166-9470</orcidid><orcidid>https://orcid.org/0000-0001-7533-5540</orcidid></addata></record> |
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| ispartof | Journal of plastic, reconstructive & aesthetic surgery, 2024-10, Vol.97, p.6-12 |
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| source | ScienceDirect Freedom Collection |
| subjects | Abdominal well-being Adult Breast Neoplasms - surgery Breast reconstruction Epigastric Arteries - transplantation Exercise Exercise levels Female Humans Mammaplasty - methods Middle Aged Patient Reported Outcome Measures Patient Satisfaction Patient-reported outcomes Perforator Flap - blood supply Physical activity Prospective Studies Quality of Life Surveys and Questionnaires |
| title | The impact of physical activity on patient-reported outcomes following deep inferior epigastric perforator flap breast reconstruction |
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