Wearable Sensing for Quantification of Upper Limb Morbidity and Recovery After Breast and Axillary Surgery – a Pilot Feasibility Trial
Association of Breast Surgery ePoster Library. Cairns A. 05/13/19; 257103; P059
Dr. Alexander Cairns
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P059
Topic: Breast surgery
Introduction: Upper limb morbidity complicates breast and axillary surgery. However there is little objective or quantitative evidence, which is largely based on anecdote or subjective measures. This work tests the feasibility of wearable activity sensors to provide objective functional data to delineate the impact of breast and axillary surgery. Methods Following approval by the National Research Ethics Service (Ref:15/LO/1038), a prospective observational study was conducted in which patients undergoing breast and axillary surgery were fitted with a lightweight activity monitor on each wrist (AX3, Axivity, UK) and asked to complete function (DASH) and quality of life (EQ-5D) questionnaires peri-operatively. Longitudinal activity data were analysed to produce recovery curves, inter-arm comparisons, and correlations with quality of life. Results: Between April and October 2018, 14 patients were recruited at Imperial College Healthcare NHS Trust. An increase in physical activity was seen post-operatively with a statistical plateau measured at 7 days. Significantly greater activity was observed in the control arm compared to the operative arm (Mann Whitney U, p=0.001). The greatest difference between arm activity was observed at post-op day 1 (35%), but was also present out to week 2 (16%). Activity levels correlated well with pre- and post-operative quality of life surveys (mean R = 0.643, p<0.05). Conclusions: This study provides objective data on arm recovery in patients undergoing breast and axillary surgery, capturing the morbidity via disparities in activity between arms. Expanding the dataset may provide a useful adjunct for personalising rehabilitation in enhanced recovery protocols.
Topic: Breast surgery
Introduction: Upper limb morbidity complicates breast and axillary surgery. However there is little objective or quantitative evidence, which is largely based on anecdote or subjective measures. This work tests the feasibility of wearable activity sensors to provide objective functional data to delineate the impact of breast and axillary surgery. Methods Following approval by the National Research Ethics Service (Ref:15/LO/1038), a prospective observational study was conducted in which patients undergoing breast and axillary surgery were fitted with a lightweight activity monitor on each wrist (AX3, Axivity, UK) and asked to complete function (DASH) and quality of life (EQ-5D) questionnaires peri-operatively. Longitudinal activity data were analysed to produce recovery curves, inter-arm comparisons, and correlations with quality of life. Results: Between April and October 2018, 14 patients were recruited at Imperial College Healthcare NHS Trust. An increase in physical activity was seen post-operatively with a statistical plateau measured at 7 days. Significantly greater activity was observed in the control arm compared to the operative arm (Mann Whitney U, p=0.001). The greatest difference between arm activity was observed at post-op day 1 (35%), but was also present out to week 2 (16%). Activity levels correlated well with pre- and post-operative quality of life surveys (mean R = 0.643, p<0.05). Conclusions: This study provides objective data on arm recovery in patients undergoing breast and axillary surgery, capturing the morbidity via disparities in activity between arms. Expanding the dataset may provide a useful adjunct for personalising rehabilitation in enhanced recovery protocols.
P059
Topic: Breast surgery
Introduction: Upper limb morbidity complicates breast and axillary surgery. However there is little objective or quantitative evidence, which is largely based on anecdote or subjective measures. This work tests the feasibility of wearable activity sensors to provide objective functional data to delineate the impact of breast and axillary surgery. Methods Following approval by the National Research Ethics Service (Ref:15/LO/1038), a prospective observational study was conducted in which patients undergoing breast and axillary surgery were fitted with a lightweight activity monitor on each wrist (AX3, Axivity, UK) and asked to complete function (DASH) and quality of life (EQ-5D) questionnaires peri-operatively. Longitudinal activity data were analysed to produce recovery curves, inter-arm comparisons, and correlations with quality of life. Results: Between April and October 2018, 14 patients were recruited at Imperial College Healthcare NHS Trust. An increase in physical activity was seen post-operatively with a statistical plateau measured at 7 days. Significantly greater activity was observed in the control arm compared to the operative arm (Mann Whitney U, p=0.001). The greatest difference between arm activity was observed at post-op day 1 (35%), but was also present out to week 2 (16%). Activity levels correlated well with pre- and post-operative quality of life surveys (mean R = 0.643, p<0.05). Conclusions: This study provides objective data on arm recovery in patients undergoing breast and axillary surgery, capturing the morbidity via disparities in activity between arms. Expanding the dataset may provide a useful adjunct for personalising rehabilitation in enhanced recovery protocols.
Topic: Breast surgery
Introduction: Upper limb morbidity complicates breast and axillary surgery. However there is little objective or quantitative evidence, which is largely based on anecdote or subjective measures. This work tests the feasibility of wearable activity sensors to provide objective functional data to delineate the impact of breast and axillary surgery. Methods Following approval by the National Research Ethics Service (Ref:15/LO/1038), a prospective observational study was conducted in which patients undergoing breast and axillary surgery were fitted with a lightweight activity monitor on each wrist (AX3, Axivity, UK) and asked to complete function (DASH) and quality of life (EQ-5D) questionnaires peri-operatively. Longitudinal activity data were analysed to produce recovery curves, inter-arm comparisons, and correlations with quality of life. Results: Between April and October 2018, 14 patients were recruited at Imperial College Healthcare NHS Trust. An increase in physical activity was seen post-operatively with a statistical plateau measured at 7 days. Significantly greater activity was observed in the control arm compared to the operative arm (Mann Whitney U, p=0.001). The greatest difference between arm activity was observed at post-op day 1 (35%), but was also present out to week 2 (16%). Activity levels correlated well with pre- and post-operative quality of life surveys (mean R = 0.643, p<0.05). Conclusions: This study provides objective data on arm recovery in patients undergoing breast and axillary surgery, capturing the morbidity via disparities in activity between arms. Expanding the dataset may provide a useful adjunct for personalising rehabilitation in enhanced recovery protocols.
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