Prehabilitation Program Improves Preoperative Fitness in Patients With Colorectal Cancer

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Prehabilitation Program Improves Preoperative Fitness in Patients With Colorectal Cancer
Prehabilitation Program Improves Preoperative Fitness in Patients With Colorectal Cancer

Engaging older patients with colorectal cancer in a prehabilitation program in the 4 weeks prior to surgery modified exercise behaviors and improved physical function in these patients thereby improving their postsurgical outcomes, a study published in the journal Supportive Care in Cancer has shown.1,2

Although mortality rates for patients with colorectal cancer are improving worldwide, recovery from surgery for the disease is often slow and difficult. Six months after surgery, only 1 in 5 patients have returned to their preoperative level of physical activity.

“Surgery places tremendous physical stress on the body in a very short period of time. So over the past 10 years, some doctors and kinesiologists have started getting their patients ready for surgery in the same way that you would prepare an athlete for an event — through individually tailored exercise programs that challenge the body and allow adaptations to occur before their operations. And we're seeing that people have a better recovery as a result,” explained Celena Scheede-Bergdahl, a kinesiologist and teacher at McGill University and a co-author of this study.

In this study, researchers sought to determine if a 4-week prehabilitation program was sufficient to modify patients' exercise behaviors and physical fitness. The researchers randomized 116 patients to a prehabilitation program (PREHAB; n = 57) or matched time control group (CTRL; n = 59).

Participants in the PREHAB group were engaged in a trimodal program that included exercise, nutritional supplementation, and counseling on relaxation techniques; those in CTRL group were included in the trimodal program postoperatively only. Activity levels were measured with the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire, and functional walking capacity was assessed with the 6-min walk test (6MWT). Measurements were obtained at baseline and at the time of surgery.

At completion of the 4-week program, patients in the PREHAB group had increased their moderate-intensity and vigorous-intensity physical activities. They also demonstrated greater improvement in the 6MWT compared with those in the CTRL group. In addition, a greater proportion of patients in the PREHAB group met the physical activity guidelines at the time of surgery.

References

1. Four weeks to prepare cancer patients for surgery. EurekAlert! web site. https://www.eurekalert.org/pub_releases/2016-12/mu-4tp120116.php. December 1, 2016. Accessed December 6, 2016.

2. Chen BP, Awasthi R, Sweet SN, et al. Four-week prehabilitation program is sufficient to modify exercise behaviors and improve preoperative functional walking capacity in patients with colorectal cancer. Support Care Cancer. 2017;25(1):33-40. doi: 10.1007/s00520-016-3379-8.
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