Huijbers, B.P. (Bregtje) (2013) Relationships between perioperative physical activity behaviour and urinary incontinence after radical prostatectomy: A longitudinal observational study. thesis, Human Movement Sciences.
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Abstract
Background: Urinary incontinence is a common sequela of radical prostatectomy. Various .intra- and perioperative strategies have been adopted to decrease the incidence and severity of post radical prostatectomy urinary incontinence (PPUI). Previous studies have demonstrated a 'continence- protective' effect of physical activity and more recently, 'ptehabilitation' has proved to reduce postoperative recovery time in other fields of medicine. The advent of robotic assisted laparoscopic radical prostatectomy (RALP) is claimed to reduce the time to regain continence and return to baseline physical functioning. Objectives: We aimed to determine the influence of preoperative physical activity behaviour on PPUI and the effect of type of surgical procedure (RALP versus open retropubic radical prostatectomy (RRP)) on PPUI and postoperative physical activity behaviour. Secondly, we aimed to assess correlations between objective and patient-reported measures for PPUI and physical activity behaviour. Methods: A total of 33 patients undergoing radical prostatectomy (RALP or RPP) and receiving physiotherapist guided perioperative pelvic floor muscle training were included. Physical activity behaviour was assessed with a portable activity monitor, the SenseWear Armband (SWA) and with the International Physical Activity Questionnaire (IPAQ) at baseline, in the week preceding surgery and in week 3 and week 6 postoperative. PPUI was assessed with 1-hour and 24-hour pad tests and with the patient-reported International Consultation on Incontinence Questionnaires (IClQs) at week 3 and week 6 postoperative. Analyses of variance and correlation techniques were used with a level of significance set at p < 0.05. Results: PPUI decreased significantly between week 3 and week 6 postoperative as measured with objective and patientreported measurements (p<O.OS). There was no significant difference in PPUI for patients with high versus moderate preoperative physical activity levels. A significant interaction effect was demonstrated for PPUI assessed with the 24- hour pad test between type of surgical procedure and time of assessment (p<O.O5). There was no difference in postoperative physical activity behaviour between patients that underwent RALP versus RRP. Moderate to very strong correlations were found between objective and patient-reported measures fot PPUI and none to moderate correlations for different measures of physical activity behaviour. Conclusion: Higher preoperative physical activity levels appeared to make no significant contribution to regaining continence early after radical prostatectomy. RALP hastens the recovery of early PPUI compared to RRP. For the assessment of PPUI, the ICIQs are reliable questionnaires. However, to assess physical activity behaviour, we recommend the use of an objective physical activity monitor instead of questionnaires.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Woude, Luc H.V. van der and Center for Rehabilitation, University Medical Center Groning and The Netherlands. |
| Supervisor name: | Supervisors: A and Hirschhom, Andrew D and Mungovan, Sean F. and Westmead Private Physiotherapy Services, Clinical Research I and Patel, Manish I. and Urological Cancer Centre and Sydney, Australia. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:52 |
| Last Modified: | 25 Jun 2020 10:52 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1277 |
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