Association between physical function before radical cystectomy for urinary bladder cancer and recovery after discharge from hospital

Abstract

Objective: This study aimed to evaluate the association between physical function before surgery and recovery measured as physical activity in daily life after discharge from the hospital. Material and methods: In total, 105 patients undergoing robot-assisted radical cystectomy were included, based on preoperative and baseline measurements taken before the intervention from a randomised controlled trial. Physical function was assessed the day before surgery using Six-minute Walk test for functional capacity and 30-s chair stand test for lower body strength. Recovery was evaluated during the week after discharge by measuring daily physical activity, including daily steps, brisk walking, sedentary time, and sit-to-stand transitions, using an accelerometer (activPAL3 micro activity monitor). Multiple regression analysis was performed to evaluate the association, adjusting for age, sex, and American Society of Anaesthesiologists score. Results: Analysis included 73 participants with valid measurements for both physical function and recovery. A significant positive association was observed between functional capacity and daily steps, with a 100-meter increase in walking distance associated with approximately 600 additional steps per day (95% confidence interval [CI]: 0.53–11.29). The association between functional capacity and sit-to-stand transitions approached significance (β = 0.05; 95% CI: −0.001 to 0.09). No significant associations were observed between physical function and brisk walking or sedentary time, nor between lower body strength and any recovery outcomes. Conclusions: Higher functional capacity is associated with higher recovery levels, as measured by physical activity after hospital discharge using activity monitors. The findings indicate that interventions aimed at improving physical function before robot-assisted radical cystectomy may enhance recovery.