Published: 2019-11-11 16:12 | Updated: 2019-11-12 09:40

New thesis about preoperative physical performance and home-based exercise in older adults undergoing abdominal cancer surgery

Hi Emelie Karlsson, PhD-student at the Division of Physiotherapy. On December 6 you will defend your thesis ”Well begun is half done: Preoperative Physical Performance and Home-based Exercise in Older Adults undergoing Abdominal Cancer Surgery”, what's the main focus of the thesis?

Portrait of Emelie Karlsson, Doctoral student at NVS.
Emelie Karlsson, PhD-student at NVS.

The main focus of the thesis is preoperative physical performance and home-based exercise in older adults undergoing abdominal cancer surgery.

Which are the most important results? 

The results demonstrate that better preoperative physical performance reduces the odds of adverse postoperative outcomes (such as complication severity, discharge destination, and reduced postoperative mobility) in older adults undergoing abdominal cancer surgery.

We did also report that a short-term, supervised, home-based exercise program at a high level of exertion is feasible with respect to compliance and acceptability for older adults prior to colorectal cancer surgery. However, recruitment was low and needs to be improved to reduce the risk of recruitment bias. In a qualitative study regarding preoperative exercise in the same target group, the participants described a gap between awareness of the benefits of physical activity and reports of performing physical activity prior to surgery. They also expressed a need of active support and guidance from health care to engage in physical exercise prior to colorectal cancer surgery.

How can this new knowledge contribute to the improvement of people’s health? 

These results indicate that assessments of physical performance (in combination with conventional preoperative risk assessments) can provide additional information for decision-making regarding each patient’s surgical pathway, and hopefully facilitate shared decision-making with the patient. The findings emphasize the importance of physical performance rather than chronological age in the preoperative context. Physical performance is a modifiable preoperative factor, an optimisation can potentially reduce adverse events after surgery, which is important for both the individual and from a socio-economic perspective.

Older adults have different needs and outcomes in relation to surgery compared to younger individuals due to a limited reserve capacity, heterogeneity and a higher incidence of comorbidity. Health care needs to be aware of this, and take on a functional perspective regarding both assessments of physical performance and preoperative physical exercise that places the older individual in focus. Perceptions from older adults scheduled for abdominal cancer surgery underlines the importance of preoperative guidance and support to enable physical activity and exercise.

What´s in the future for you? Will you keep on conducting research? 

I will combine work as a clinical physiotherapist with R&D, and also continue with some research-related projects.