Patients Recovering from Abdominal Surgery Who Walked with Volunteers Exhibited Improved Postoperative Recovery Profiles During Hospitalization: Reply

Cakir et al. [1] raise an excellent point regarding the mental health of post-operative patients. We too were surprised by the lack of statistically significant difference in mental health scores between the post-operative walking group and the control group. Because our study design focused on the effect of walking on the physical recovery profile, we did not have pre-participation mental health profiles available. We agree that the similarity in post-operative mental health scores could be a result of the walking group having a lower pre-operative mental health score than the control group, thus making the final scores a significant finding. Another possibility is that the walking intervention’s effect on mental health is greatest in the first few weeks postoperatively. We may have missed this effect in our study of patients who were 30 days status post-surgery. Lastly, our study is limited by a small sample size. We may have lacked the statistical power to elucidate a difference in mental health scores between post-operative patients who walked and those that did not. We agree that future research should more thoroughly incorporate mental health evaluations in the preand postoperative period using a tool such as the Warwick–Edinburgh Mental Well-being Scale (WEMWBS) [2].