Difference Between Walking Parameters During 6 Min Walk Test Before and After Abdominal Surgery in Colorectal Cancer Patients

TL;DR

This study shows that colorectal cancer patients experience changes in walking performance and heart rate after abdominal surgery, with bigger effects in overweight individuals.

Contribution

The study identifies significant post-surgery changes in 6 min walk test parameters, particularly heart rate differences in overweight patients.

Findings

Postoperative heart rate during walking is significantly higher in overweight and obese patients.

Walk distance differs significantly between men and women after surgery.

Age influences the number of steps taken during the 6 min walk test.

Abstract

This study aims to show the difference in 6 min walk test parameters before and after major abdominal surgery in patients with colorectal cancer. We measured walking speed, number of steps, distance, and heart rate during walking. We analyzed this parameter overall and by groups. Grouping variables were gender, age, oncological diagnosis, other comorbidities and drug use, neoadjuvant therapy before surgery, level of physical activity before surgery, BMI, and duration of surgery. Based on our results, we can predict cardiorespiratory response after surgery during walking. This is primarily applied to overweight and obese patients whose heart rate during walking is significantly higher after surgery.

Background/Objectives: Colorectal cancer is a significant health problem worldwide. Surgery is the primary curative treatment for most colorectal cancers. Cardiopulmonary exercise testing is now performed widely before surgery, and it is the most objective and precise means of evaluating pre-surgical physical fitness. Also, we can use the 6 min walk test to measure cardiorespiratory fitness before surgery. Methods: We included colorectal patients who were awaiting open abdominal or laparoscopic surgery. After admission to the hospital, patients who signed informed consent forms fulfilled a short questionnaire about health and physical status, preoperative physical activities, and quality of life questionnaire (EORTC QLQ-C30). Patients performed a 6 min walk test (6MWT) 2 days before surgery and 7 days after surgery. 6MWT is a tool for measuring the functional status of fitness. Also, they fulfilled the quality of recovery questionnaire (QoR 15) 7 days after surgery. Results: In a final analysis, we included 72 patients with a mean age of 62.48. We compared the number of steps, walk distance, average and maximal walk speed, and average and maximal heart rate before and after surgery, overall, and by group. Our findings show a statistically significant difference between men and women in the walk distance (F = 4.99, p = 0.02) The number of steps showed a statistically significant difference according to patients’ ages (F = 2.90, p = 0.02). Also, we detected differences in the average and maximum heart rate during walking when comparing body mass index (average heart rate F = 5.72, p = 0.00, maximum heart rate F = 2.52, p = 0.04). Conclusions: Our study provides evidence that average and maximal heart rate during the 6 min walk test was higher in the postoperative period, especially in overweight and obese participants.

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