The Optimal Physical Recovery After Hospitalization (OPRAH) intervention to improve physical activity and protein intake after oncological surgery: feasibility study.

Suzanne ten Dam, Marieke van der Heide, Marijke de Leeuwerk, Hinke Kruizenga, Edwin Geleijn, Vincent de Groot, Marike van der Leeden, Marike van der Schaaf
Purpose:

This study aims to determine the feasibility of the OPRAH intervention, consisting of a smartphone app enabling self-monitoring of physical activity and protein intake in combination with coaching by a healthcare professional after hospitalization, and corresponding study procedures.  


Methods:

This feasibility study was performed as a non-randomised single institutional prospective one-armed intervention study at the Amsterdam UMC, location VUmc, from September 2021 till April 2022. Patients were eligible to participate if they were scheduled for oncologic GI or lung cancer surgery at Amsterdam UMC, were 18 years of age or older, the surgery had a curative intent, there was an indication for postoperative hospital stay ≥ 2 nights, and they were able to complete online questionnaires in Dutch and provide informed consent. Exclusion criteria were: wedge excision lung, surgery with open/close procedure, no access to a mobile device compatible for applications, less than 5 days between inclusion and surgery, patients who were wheelchair dependent, Mini-Mental State Examination (MMSE) ≤ 24 and already participating in a conflicting study. Patients received an app and ankle-worn accelerometer one week before surgery, using it for up to six weeks post-discharge. They also received coaching from a physiotherapist and dietician.  Participation and completion rate, user adherence, system usability score (SUS), experiences and safety were investigated using predefined criteria to assess the feasibility. 


Results:

In total, 32 patients were included, with participation and completion rates of 69% and 75%, respectively. User adherence to wearing the accelerometer was deemed satisfactory (91%), while user adherence to protein intake was suboptimal (59%). The mean SUS was acceptable (73.5). Patient experiences were predominantly positive, although some patients mentioned a lack of options in the protein registration tool. Almost all patients (95%) recommend using the Atris app to other patients after surgery.



Conclusion(s):

This study suggests that self-monitoring of physical activity and protein intake, in combination with remote coaching by a healthcare professional, is feasible in patients after oncological surgery, taking into account the changes that need to be made in the protein self-registration tool, to improve user adherence. When conducting an RCT, the sample size must take into account a higher drop-out rate. Other study procedures were feasible.

Implications:

  • Patients after oncological surgery are positive about a blended intervention to increase physical activity and protein intake and would recommend it to others.
  • Self-monitoring of physical activity after oncological surgery is feasible. Modifications to the app are needed to improve the feasibility of self-registration of protein intake
Funding acknowledgements:
This project was partly funded by Amsterdam Movement Sciences Institute and Cancer Center Amsterdam.
Keywords:
Physical activity
Nutrition
Self-monitoring
Primary topic:
Oncology, HIV and palliative care
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The Medical Research Ethics Committee of the Amsterdam University Medical Centre, location VU medical Centre (VUmc)
Provide the ethics approval number:
registration number 2021.0112
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
Yes

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