J.Jpn. Surg. Soc.. 88(4): 432-439, 1987

---

Original article

CLINICAL SIGNIFICANCE OF A PHYSICAL ACTIVITY INDEX BASED ON CALORIMETRY IN THE ASSESSMENT OF QUALITY OF LIFE AFTER TOTAL GASTRECTOMY

In order to characterize the objective diagnostic criteria concerning quality of life (QL) of patients after total gastrectomy, a physical activity index (PAI) or a concept of daily physical activity was developed. Sixty patients of gastric cancer, of whom 38 patients underwent long loop Roux-en-Y gastrojejunostomy (LLRY) procedure after total gastrectomy, 13 patients gastroduodenostomy (Billroth I) and 9 patients gastrojejunostomy (Billroth II) after subtotal gastrectomy, respectively, were evaluated as part of this study. In addition, 3 cases of pancreatoduodenectomy (PD) and 5 cases of total esophagectomy were also evaluated. The evaluation of QL was based upon a clinical assessment and administration of patient questionaire. The assessment of the PAI was performed by measuring the individual’s whole day energy expenditure based upon 24 hour heart rate ratio (24h-HRR) method and the basal metabolic energy expenditure. The daily physical activity was graded into four categories according to the PAI value ; light, moderate, moderately heavy and heavy. The results obtained were as follows:
1. The value of the energy expenditure predicted by 24h-HRR method and that based on the results of bicycle ergometry (VO₂/HR method) showed close correlation.
2. There was no significant difference in the whole day energy expenditure among four operative procedure groups (Billroth I, Billroth II, LLRY and total esophagectomy).
3. More than 80 per cent of LLRY patients, whose QL was evaluated as “excellent” or “good”, showed no less than “moderate” PAI. In addition, one of the four patients whose QL was “fair” was categorized into “light” and the remaining three were “moderate”.
4. All of the PD patients, whose QL was “good”, showed no less than “modrately heavy” PAI. The patients of total esophagectomy, whose QL was “good ” (2 cases), “fair ” (2 cases) and “poor” (one case), showed the PAI value of “modrately heavy”, “moderate” and “light”, respectively.
Therefore, the grade of the PAI is directly proportional to the QL. These results establish that PAI can be used as appropriate clinical parameter for objectively characterizing the diagnostic criteria of the QL after total gastrectomy or other gastrointestinal surgery.

---

---

To read the PDF file you will need Adobe Reader installed on your computer.