POP -Active
Research type
Research Study
Full title
Exercise capacity and physical activity: a survey of patients attending pre-operative anaesthetic fitness assessment services in NHS Manchester
IRAS ID
238953
Contact name
Daniel Conway
Contact email
Sponsor organisation
Manchester University NHS Foundation Trust
Duration of Study in the UK
2 years, 11 months, 25 days
Research summary
Research Summary
Over ten million operations take place in the UK NHS every year with surgical options available for previously untreatable conditions in patient who are not always very fit. Complications following major surgery occur in 15% of patients, and are associated with reduced survival and quality of life.
Before major surgery, anaesthetists assess fitness with blood tests, simple grip strength and a cardiopulmonary exercise test (CPET). Presently, these assessments do not include a self-reported measure of physical activity.
The International Physical Activity Questionnaire (IPAQ) is a self-reported tool designed to measure particularly activities related to cardiopulmonary fitness. Studies in healthy volunteers suggest that IPAQ correlates with exercise capacity eg VO2max. IPAQ has been used to assess physical activity in patients having weight loss surgery, but not major surgery such as solid cancer resection or vascular reconstructive surgery.Aims and Objectives
Th study aims to assess the correlation between declared preoperative activity levels with routinely performed, objective measures of physical fitness and strength in preoperative major surgical patients and how these relate to important clinical outcomes following surgery.
We also want to find out where people currently go to do exercise and how interested they would be in a free programme, in development, which intends to improve activity levels in patients preparing to undergo major surgery.Summary of Results
Little is known about the physical activity of people preparing for major surgery. We explored what people said about their physical activity and compared this to exercise capacity measured by a cardiopulmonary exercise test (CPET) which the same people did on an exercise bike.
Methods We interviewed 84 consecutive patients attending for a CPET which was part of their 'work-up' for major surgery. They agreed to complete the International Physical Activity Questionnaire Short Form which estimates total physical activity, time spent walking and sedentary time. We compared this with exercise capacity measured by CPET.
Results 74 people completed a CPET and returned a questionnaire. 33 respondents reportedly achieved the recommended levels of moderate and/or vigorous activity per week. Peak oxygen consumption which measures exercise capacity, correlated only weakly with how much walking people did per week and handgrip strength. People's daily activity showed no correlation with ventilatory equivalents which measure the efficiency of breathing during exercise.
We followed up of survival using NHS electronic record systems at 2 years following recruitment to the study. Almost everyone had surgery but we found that 24 participants had died and 60 survived this time period. We will conduct analysis to review correlation with survival for self-reported activity but also other factors such as whether the patients had surgery or not.
Conclusion. We found that a minority of people preparing for surgery undertook moderate or vigorous activity in the preceding week. Declared physical activity only weakly correlated with an objective measure of exercise capacity measured by CPET. Sadly within two years, 24 patients had died. Further analysis will be conducted to ascertain correlation between declared activity and survival.REC name
North West - Greater Manchester Central Research Ethics Committee
REC reference
18/NW/0121
Date of REC Opinion
8 Mar 2018
REC opinion
Further Information Favourable Opinion