Actigraphy to Evaluate Changes in Physical Activity After Autologous Breast Reconstruction

Area of Science:

• Plastic Surgery
• Orthopedics
• Vascular Surgery

Background:

• Early ambulation post-surgery is crucial for preventing venous thromboembolism (VTE).
• Current methods for assessing postoperative physical recovery rely on subjective patient reports, leading to uncertainty about actual recovery timelines.
• Quantifying return to baseline ambulatory status is essential for optimizing VTE prophylaxis strategies.

Purpose of the Study:

• To objectively measure the time required for patients to return to their preoperative ambulatory level after breast reconstruction.
• To utilize actigraphy devices for precise quantification of physical activity post-surgery.

Main Methods:

• Actigraphy devices monitored preoperative and postoperative physical activity (daily steps) and resting heart rate (HR) in patients undergoing autologous breast reconstruction.
• "Baseline" was defined as the average daily steps in the 14 days prior to surgery.
• Return to baseline was defined as achieving ≥95% of baseline steps over a 7-day average, or by 8 weeks postoperative.

Main Results:

• Seventeen patients undergoing deep inferior epigastric perforator (DIEP) flap breast reconstruction were studied.
• On average, patients took longer than 28 days to return to baseline activity; only 8 of 17 patients returned by 8 weeks postoperative.
• Resting heart rate normalized by postoperative week 4, despite slower return to baseline step counts.

Conclusions:

• Postoperative return to baseline physical activity levels may be significantly delayed after free flap breast reconstruction.
• Surgeons might underestimate the duration of physical decline, potentially leading to inadequate VTE prophylaxis.
• Objective actigraphy data is vital for accurate assessment of recovery and VTE risk management.