Early ambulation and increased physical activity have long been recognized as important for postoperative recovery, and they are core components of enhanced recovery programs after noncardiac and cardiac surgery. An important part of promoting activity and mobility is accurate and timely patient-level measurement of movement. However, such measurement is difficult in hospital settings, as current measurements are typically limited to observations by staff or patient report, which are often not granular, standardized, or complete. This lack of measurement contributes to what has been characterized an “epidemic of low mobility” in hospitalized patients that may be particularly important for older adults, who are at the greatest risk for impaired mobility and poor functional recovery.

Wearable activity monitors can provide novel and detailed data on activity and mobility after surgery, which could be used to guide clinical care protocols, provide research insights, and display information to patients to increase activity. Scattered reports in noncardiac and cardiac surgical populations at different times of recovery have reported associations of activity and mobility metrics with some postoperative outcomes. However, there are a myriad of monitoring devices that can be used, with varying measurement properties and costs. As an alternative to wearable monitors, structured clinical observations of activity and mobility require no extra hardware but provide less granular measurements. For cardiac surgery programs considering all of these options, comprehensive data comparing different monitoring approaches are needed to understand which monitoring approach provides the most clinically relevant information and to establish thresholds of activity and mobility that can be used to target activity after surgery.

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Mishita
Jornal co-ordinator
Journal of Heart and Cardiovascular Research