Exercise makes patients fit – UMC Utrecht

Movement is good! Both before and during hospitalization. It keeps the condition up and makes the muscles stronger. As a result, patients are less dependent on the care of others, it reduces the risk of complications and patients may be able to return home sooner. What does UMC Utrecht do to get patients moving?

The recovery and vitality of the patient are central to UMC Utrecht. That is why we encourage a healthy lifestyle in food, (night) rest, stress reduction and exercise. For example, on April 1, 2022, the prehabilitation program CRC (colorectal carcinoma) started: a program to get patients with colon cancer in an optimal physical, psychosocial and mental condition within six weeks of their diagnosis. And to encourage movement during hospitalization and to prevent unnecessary inactivity, UMC Utrecht has recently started using a movement sensor in the surgical oncology department. This makes exercise behavior an objective outcome measure and transparent for both healthcare providers and patients.

Not just moving, but a total package

Patients with colorectal cancer start the program to improve their condition and lifestyle during the waiting time before their surgery. Elsbeth Berendsen, nurse specialist and project leader of the prehabilitation program, explains: “Exercise improves the patient’s physical condition and recovery capacity. They use their muscles, their blood flows, their resistance increases, and any excess weight is reduced. It is a multimodal approach: there is a training program, a nutrition program and mental support. If applicable, then smoking cessation is also addressed. This approach ensures interaction between the different modules. It really is an integrated total package.”

Good preparation and information

In the period before the operation, patients train three times a week with the physiotherapist and on the other days at least one hour a day independently. Often in their own familiar environment. They keep everything in a diary. Patients are well prepared with educational material such as a animation video and a infographic, have permanent contacts for the various disciplines and can go to a special outpatient clinic in the UMC Utrecht. Elsbeth: “Prehabilitating can ultimately lead to a shorter hospital stay, a better recovery, fewer complications and fewer readmissions for the patient. In short: for a better quality of life. Patients are happy with the extra attention they receive. We think along with them on all fronts. We take them by the hand and patients also motivate each other. It gives them satisfaction, something like, ‘I’m doing meaningfully in my waiting period for the surgery’.”

Movement sensor makes movement measurable

Movement is important not only for, such as the prehabilitation program, but also during hospitalization. Despite the fact that everyone sees the importance of exercise, patients in hospital spend an average of 60 to 90 percent of the day lying or sitting, while they are often able to move. UMC Utrecht uses a movement sensor to stimulate movement during hospitalization. Petra Bor, physiotherapist and researcher at UMC Utrecht, explains: “In the oncological surgery department, we use a movement sensor for all patients with an expected hospital stay of more than three days. Patients wear the motion sensor around the ankle. This makes the movement behavior visible to caregivers in HiX – the system with the patient’s basic data – and, if the patient wants it, on a screen in the ward. This can stimulate the patient to get and keep moving! It helps healthcare providers to give patients tailor-made advice.” At the moment, UMC Utrecht only uses the motion sensor in surgical oncology. The aim is to use these in other departments of the UMC Utrecht as well.

The motion sensor in the picture