{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T09:02:24Z","timestamp":1789376544170,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Methods<\/jats:title>\n                    <jats:p>The role of early and increased activity on postoperative recovery is well established, yet the impact of its day\u2010to\u2010day variability remains unclear. This retrospective cohort study examined associations between early in\u2010hospital postoperative physical activity trajectories and postoperative outcomes among 218 surgical oncology patients from the University Medical Center Utrecht. Group\u2010based trajectory modelling identified subgroups based on daily activity patterns over the first five postoperative days. Primary analysis assessed associations between trajectory and length of stay (LOS), complications, and 30\u2010day readmission. Secondary analysis explored sociodemographic and clinical predictors of trajectory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three trajectories were identified: Minimal (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200972), Moderate (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200997), and Rapid Activity Recovery (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200949). Compared with the Minimal group, Rapid Activity Recovery patients had a 38% shorter LOS (MR: 0.62, 95% CI: 0.50\u20130.77). Trajectory was not associated with complications or readmissions. Female sex and higher American Society of Anesthesiologists Physical Status Classification were associated with lower odds of belonging to the Rapid Activity Recovery group (OR: 0.33, 95% CI: 0.14\u20130.78 and OR: 0.38, 95% CI: 0.17\u20130.84, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Favorable early postoperative activity trajectories were associated with shorter hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Further exploration of real\u2010time trajectory\u2010based assessment towards the improvement of postoperative care is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70398","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T08:03:02Z","timestamp":1789372982000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Plotting the Path to Recovery: Group\u2010Based Trajectory Modelling of Physical Activity After Major Oncological Surgery to Predict Postoperative Outcomes"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8713-7443","authenticated-orcid":false,"given":"Ella","family":"Jansen","sequence":"first","affiliation":[{"name":"Utrecht University Utrecht the Netherlands"},{"name":"Department of Rehabilitation, Physiotherapy Science and Sport University Medical Center Utrecht Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1196-276X","authenticated-orcid":false,"given":"Carlos de Miguel","family":"Llorente","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Physiotherapy Science and Sport University Medical Center Utrecht Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8494-349X","authenticated-orcid":false,"given":"Petra","family":"Bor","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Physiotherapy Science and Sport University Medical Center Utrecht Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3159-0322","authenticated-orcid":false,"given":"Jan Willem","family":"van den Berg","sequence":"additional","affiliation":[{"name":"Department of Surgery University Medical Center Utrecht Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4715-685X","authenticated-orcid":false,"given":"Karin","family":"Valkenet","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Physiotherapy Science and Sport University Medical Center Utrecht Utrecht the Netherlands"},{"name":"Research Group Innovation of Human Movement Care HU University of Applied Sciences Utrecht Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.ijsu.2017.06.085","article-title":"The Relationship Between Physical Activity and Post\u2010Operative Length of Hospital Stay: A Systematic Review","volume":"44","author":"Abeles A.","year":"2017","journal-title":"International Journal of Surgery"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"121","DOI":"10.2217\/cer-2021-0258","article-title":"Early Mobilization in Enhanced Recovery After Surgery Pathways: Current Evidence and Recent Advancements","volume":"11","author":"Tazreean R.","year":"2022","journal-title":"Journal of Comparative Effectiveness Research"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1177\/02692155211043267","article-title":"The Effectiveness of Pre\u2010 and Post\u2010Operative Rehabilitation for Lung Cancer: A Systematic Review and Meta\u2010Analysis on Postoperative Pulmonary Complications and Length of Hospital Stay","volume":"36","author":"Xu X.","year":"2022","journal-title":"Clinical Rehabilitation"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","DOI":"10.3389\/fsurg.2026.1726792","article-title":"The Effect of Step Count on Pain and Quality of Recovery After Cholecystectomy: A Prospective Observational Cohort Study","volume":"13","author":"Cetin B.","year":"2026","journal-title":"Frontiers in Surgery"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2018.7673","article-title":"Association of Wearable Activity Monitors With Assessment of Daily Ambulation and Length of Stay Among Patients Undergoing Major Surgery","volume":"2","author":"Daskivich T. 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