The influence of abdominal surgery on energy expenditure and working capacity

Detta är en avhandling från Department of Health Sciences, Division of Physiotherapy, Lund, University Hospital. S-221 85 Lund, Sweden

Sammanfattning: The overall aim of this work was to study the influence of surgery on energy expenditure (EE) during working capacity measurements and during walking. In the first study the aim was to investigate whether two different devices were sensitive enough to reveal differences in energy expenditure during treadmill walking, and if the measurements were reproducible. It was shown that an airflow of 42.5 l/min-1, the limit of the Datex metabolic monitor, is not suitable for measuring EE during walking, while the SensorMedics 2900? fulfilled our demands on validity and reliability. In the second study the purpose was to determine whether weight reduction induced by vertical banded gastroplasty (VBG) altered the energy expenditure during preset and comfortable walking speeds. In summary, surgical induced weight reduction reduced the energy expenditure during walking at preset walking speed, and made it possible to increase the comfortable walking speed. The findings corresponded to a change in quality of life. In the third study the purpose was to ascertain whether the energy expenditure during treadmill walking changed during postoperative chemotherapy. It could be shown that the patients had a decreased comfortable walking speed after 5-7 cycles of chemotherapy but recovered 6-10 weeks after having completed the treatment. In addition energy expenditure decreased during treatment and recovered afterwards, and the changes corresponded to the changes in the SF-36 subscales general health and vitality. In the fourth study the purpose was to evaluate resting energy expenditure and the working capacity of patients who had undergone ileal pouch anal anastomosis (IPAA) for ulcerative colitis. It could be shown that the patients had resting energy expenditure and working capacity corresponding to those of healthy subjects. The purpose of the fifth study was to measure the working capacity in patients who had undergone continent intestinal urinary diversion after radical cystectomy. The conclusion was that the patients had a working capacity equal to that of a control group. Furthermore, the patients? rating of their well-being and health did not differ from those of a control group.

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