Delineating upper limb longitudinal recovery after simple mastectomy, implant or autologous breast reconstruction using wearable activity monitors
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Introduction
The demand for breast reconstruction has increased owing to the established benefits for patients. Given the long-term survivorship, objective data are vital to aid patients in making treatment decisions. This prospective longitudinal observational study was carried out to objectively quantify the impact of simple mastectomy (Mx), implant-based reconstruction (IBR) and deep inferior epigastric perforator (DIEP) on upper limb (UL) activity using wearable activity monitors (WAMs).
Methods
Forty-eight consecutive patients who underwent breast and reconstructive surgery were identified from operating schedules. Recruited participants were invited to wear WAMs on both wrists for an average of 3 days preoperatively, for 2 weeks post-operatively and more than 6 months post-operatively.
Results
A significantly greater reduction in gross physical activity as a percentage of preoperative activity was observed in DIEP compared with Mx and IBR patients across week 1 (median: 40% versus 62% versus 62%; p<0.001) and week 2 (median: 60% versus 77% versus 84%; p<0.001). In the long-term follow-up, the average activity had reached or exceeded their baseline levels for all operative procedures, Mx=114%, IBR=98% and DIEP=103%. DIEP was an independent predictor of recovery in weeks 1 (F=4.796, p=0.043) and 2 (F=7.306, p=0.015).
Conclusion
Despite DIEP patients having the lowest UL activity level in the acute post-operative period when compared with Mx and IBR patients, average activity levels returned to baseline in the long-term for all procedures. Objective monitoring of recovery using WAMs can support the development of a personalised rehabilitation programme for those at risk of developing complications.
The demand for breast reconstruction has increased owing to the established benefits for patients. Given the long-term survivorship, objective data are vital to aid patients in making treatment decisions. This prospective longitudinal observational study was carried out to objectively quantify the impact of simple mastectomy (Mx), implant-based reconstruction (IBR) and deep inferior epigastric perforator (DIEP) on upper limb (UL) activity using wearable activity monitors (WAMs).
Methods
Forty-eight consecutive patients who underwent breast and reconstructive surgery were identified from operating schedules. Recruited participants were invited to wear WAMs on both wrists for an average of 3 days preoperatively, for 2 weeks post-operatively and more than 6 months post-operatively.
Results
A significantly greater reduction in gross physical activity as a percentage of preoperative activity was observed in DIEP compared with Mx and IBR patients across week 1 (median: 40% versus 62% versus 62%; p<0.001) and week 2 (median: 60% versus 77% versus 84%; p<0.001). In the long-term follow-up, the average activity had reached or exceeded their baseline levels for all operative procedures, Mx=114%, IBR=98% and DIEP=103%. DIEP was an independent predictor of recovery in weeks 1 (F=4.796, p=0.043) and 2 (F=7.306, p=0.015).
Conclusion
Despite DIEP patients having the lowest UL activity level in the acute post-operative period when compared with Mx and IBR patients, average activity levels returned to baseline in the long-term for all procedures. Objective monitoring of recovery using WAMs can support the development of a personalised rehabilitation programme for those at risk of developing complications.
Date Issued
2025-05-01
Date Acceptance
2025-02-08
Citation
Journal of Plastic, Reconstructive and Aesthetic Surgery, 2025, 104, pp.113-122
ISSN
0007-1226
Publisher
Elsevier
Start Page
113
End Page
122
Journal / Book Title
Journal of Plastic, Reconstructive and Aesthetic Surgery
Volume
104
Copyright Statement
© 2025 The Author(s). Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
License URL
Identifier
10.1016/j.bjps.2025.02.012
Subjects
Upper limb activity
Upper limb recovery
Simple mastectomy, Deep inferior epigastric perforator reconstruction
Implant breast reconstruction
Publication Status
Published
Date Publish Online
2025-02-13