Developing A Perioperative Exercise Regimen For Elderly Liver Cancer Patients Based On Evidence-based Principles

ObjectiveThe aim of this study is to construct a set of exercise management program suitable for elderly liver cancer patients in the perioperative period,in order to improve the rehabilitation effect,reduce the incidence of complications,and enhance the quality of life for elderly liver cancer patients in the perioperative period,providing scientific basis for the rehabilitation of elderly liver cancer patients in the perioperative period.MethodsBased on the theoretical guidance of the JBI Evidence-Based Healthcare Model,this study retrieved relevant guidelines and literature on exercise for elderly liver cancer patients in the perioperative period from domestic and international sources.After strict quality evaluation and combining with the FAME principles to determine the level of evidence,the best evidence summary for exercise in elderly liver cancer patients during the perioperative period was formed.Guided by the theory of accelerated rehabilitation and the concept of exercise rehabilitation,this study initially drafted a management plan for exercise during the perioperative period for elderly liver cancer patients based on the best evidence summary.After two rounds of expert consultation,the final draft of the management plan for exercise during the perioperative period for elderly liver cancer patients was formed.ResultsA total of 27 articles were included in this study,including 4 clinical guidelines,7expert consensus,7 systematic reviews,6 randomized controlled trials,and 3 quasiexperimental studies.From 7 aspects,including the necessity of exercise,preoperative exercise assessment,preoperative exercise program,postoperative exercise program,exercise monitoring,precautions,and effect evaluation,30 pieces of evidence were summarized.In two rounds of expert inquiry,the expert participation rates were 100% and 93.3%,and the expert authority levels were 0.88 and 0.92.The Kendall’s coefficient of concordance for the importance of indicators was 0.292 and 0.168,and the Kendall’s coefficient of concordance for the operability of indicators was 0.215 and 0.204.After two rounds of inquiry,the mean score of all items was >0.35,the coefficient of variation(CV)was <0.25,and the expert opinions tended to be consistent.Finally,the exercise management program for elderly liver cancer patients in the perioperative period was formed,including 6 primary items,16 secondary items,and 60 tertiary items.ConclusionThe exercise management plan for elderly liver cancer patients in the perioperative period constructed in this study is rigorous in process and has reliability and rationality,providing reference for exercise management of elderly liver cancer patients in the perioperative period.In the future,empirical research needs to be conducted in combination with specific practices and patient needs,continuously improving in clinical application,in order to effectively guide rapid recovery in the perioperative period for elderly liver cancer patients.