Feasibility of a novel exercise prehabilitation programme in patients scheduled for elective colorectal surgery: a feasibility randomised controlled trial

Northgraves, Matthew J.; Arunachalam, Lakshmanan; Madden, Leigh A.; Marshall, Philip; Hartley, John E.; MacFie, John; Vince, Rebecca V.

Abstract

© 2019, The Author(s). Background and objectives: To investigate the feasibility of delivering a functional exercise-based prehabilitation intervention and its effects on postoperative length of hospital stay, preoperative physical functioning and health-related quality of life in elective colorectal surgery. Materials and methods: In this randomised controlled feasibility trial, 22 elective colorectal surgery patients were randomly assigned to exercise prehabilitation (n = 11) or standard care (n = 11). Feasibility of delivering the intervention was assessed based on recruitment and compliance to the intervention. Impact on postoperative length of hospital stay and complications, preoperative physical functioning (timed up and go test, five times sit to stand, stair climb test, handgrip dynamometry and 6-min walk test) and health-related quality of life were also assessed. Results: Over 42% of patients (84/198) screened were deemed ineligible for prehabilitation due to insufficient time existing prior to scheduled surgery. Of those who were eligible, approximately 18% consented to the trial. Median length of hospital stay was 8 [range 6–27] and 10 [range 5–12] days respectively for the standard care and prehabilitation groups. Patterns towards preoperative improvements for the timed up and go test, stair climb test and 6-min walk test were observed for all participants receiving prehabilitation but not standard care. Conclusions: Despite prehabilitation appearing to convey positive benefits on physical functioning, short surgical wait times and patient engagement represent major obstacles to implementing exercise prehabilitation programmes in colorectal cancer patients.

Citation

Northgraves, M. J., Arunachalam, L., Madden, L. A., Marshall, P., Hartley, J. E., MacFie, J., & Vince, R. V. (2019). Feasibility of a novel exercise prehabilitation programme in patients scheduled for elective colorectal surgery: a feasibility randomised controlled trial. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, https://doi.org/10.1007/s00520-019-05098-0

• Journal Article Type: Article
• Acceptance Date: Sep 20, 2019
• Online Publication Date: Nov 12, 2019
• Publication Date: Nov 20, 2019
• Deposit Date: Nov 12, 2019
• Publicly Available Date: Nov 12, 2019
• Journal: Supportive Care in Cancer
• Print ISSN: 0941-4355
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1007/s00520-019-05098-0
• Keywords: Prehabilitation; Colorectal surgery; Exercise programme
• Public URL: https://hull-repository.worktribe.com/output/3134871
• Publisher URL: https://link.springer.com/article/10.1007%2Fs00520-019-05098-0
• Additional Information: Received: 25 July 2019; Accepted: 20 September 2019; First Online: 12 November 2019; : ; : The authors declare that they have no conflict of interest.
• Contract Date: Nov 12, 2019