Abstract
BackgroundPre-operative exercise training improves HR components of fitness and HRQoL following hospital-based programmes.ObjectiveTo assess compliance and adherence of a pragmatic community-based preoperative exercise programme and its effect on health-related (HR) components of fitness and health-related quality of life (HRQoL).MethodsThirty-two surgical oncological participants (15 prostate cancer and 17 colorectal cancer (CRC)) were recruited and assessed to measure HR components of fitness (strength and functional exercise capacity) and HRQoL. An exercise programme was prescribed in the time available prior to surgery with repeat assessments pre-operatively.ResultsTwenty-four participants (14 prostate cancer and 10 CRC) completed the full study (75% compliance). Exercise training was delivered over a median interquartile range (IQR) of 4 (3-4) weeks and 2 (1–3) weeks for the prostate cancer and CRC participants, with > 80% adherence. From baseline to post-exercise intervention, there were significant improvements in lower body strength in the prostate cancer group (p = 0.045), the CRC group (p = 0.001), and in both groups overall (p = .001). Additionally, there were statistically significant improvements in HRQoL: global health status for CRC group (p = 0.025) and for both groups overall (p = 0.023); emotional health subscale for the prostate cancer group (p = 0.048) and for both groups overall (p = 0.027); nausea/vomiting/pain subscale for the CRC group (p = 0.005) and for both groups overall (p = 0.030); and for health scale status for the prostate cancer group (p = 0.019) and for both groups overall (p = 0.006).ConclusionThis community-based pre-operative exercise programme showed acceptable compliance and adherence rates, and significantly increased upper and lower body strength and HRQoL. Pre-operative exercise training should be considered as early as possible in the surgical-oncology pathway and respected within patient scheduling.
Highlights
Pre-operative exercise training improves HR components of fitness and health-related quality of life (HRQoL) following hospitalbased programmes
6 were unable to attend for follow-up assessment either due to advancement of the date of surgery (n = 3), work commitments (n = 1), holidays (n = 1) or a medical issue (n = 1) and 1 dropped out due to disease progression
Note: three of the colorectal cancer (CRC) participants that completed the study were scheduled for neoadjuvant cancer treatment in the first instance
Summary
Pre-operative exercise training improves HR components of fitness and HRQoL following hospitalbased programmes. A recent report demonstrated that a supervised pre-operative exercise programme (as part of a multi-modal prehabilitation programme) showed significant improvements on functional capacity and muscle strength and had two times higher chances of returning to baseline fitness after surgery compared to the home-based exercise group (Awasthi et al 2018). Community-based exercise programmes are recommended interventions by the World Health Organization to promote physical activity for people living with an illness. They include a structured set of exercises designed for individuals with specific exercise needs and commonly involve a group of people with similar illnesses exercising under the supervision of a physiotherapist or a fitness instructor, with the goal of promoting and continuing regular exercise in the community (Salbach et al 2014; Smith et al 2011; Stuart et al 2009). Few studies have explored community-based training in the preoperative setting, the early data is encouraging and shows that they are feasible and effective (Rao et al 2012; Singh et al 2017)
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