Getting up and walking after surgery has long been standard advice. Now, a new study puts numbers on it.
Researchers found that every extra 1,000 steps a day after an operation was linked to an 18 percent lower chance of complications, 16 percent lower odds of re-admission, and 6 percent shorter hospital stays.
The association held across different types of procedures and patient health levels, according to findings published in the Journal of the American College of Surgeons.
The researchers analysed data from 1,965 adult patients undergoing inpatient surgery and said step counts from a wearable device offer a practical tool to track recovery in real time.
The findings showed that a patient’s step count following surgery is a “powerful” predictor of recovery, outperforming other metrics such as heart rate variability and self-reported wellness.
“We tell patients that they need to get up and walk after an operation, but we don’t have a good sense of how much they’re actually moving,” said study senior author Professor Timothy Pawlik.
“Wearables give us an objective, continuous readout.”
“Instead of asking how you feel, we can see that you’re up and moving, which is a very actionable signal of how your recovery is progressing.”
Incremental increases in daily steps were also associated with lower odds of 30-day and 90-day hospital re-admissions, potentially indicating a dose-dependent response.
By contrast, post-operative changes in heart rate variability and self-reported “wellness” scores were not independently associated with length of stay, complications, or re-admissions.
Professor Pawlik, who is also chair of the department of surgery at The Ohio State University Wexner Medical Center, said the results demonstrate a scenario similar to that of the chicken and the egg.
“People who feel better are naturally more likely to be up and around,” he said.
“However, the signal is so strong that it suggests step count is not just a marker of wellness, but a key component of it.”
“Seeing a patient’s step count drop can be an early indicator to intervene, perhaps by involving physical therapy or checking in more frequently.”
He said the findings align with a 2023 study which found that patients who took more than 7,500 steps per day before surgery had a 51 percent lower risk of post-op complications.
“If a patient’s goal is 8,000 steps before surgery and 6,000 on postoperative day three, they can see if they’re hitting those targets. It gives them a concrete goal and gives us objective data to help decide if they’re ready for discharge or if they need more support at home.”
Pawlik also said that all exercise plans should be discussed with a doctor and that the number of steps any individual takes each day should be considered in light of other health issues.
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