MP38-14 IMPLEMENTING A MULTIMODAL PREHABILITATION PROGRAM IN A HIGH-VOLUME BLADDER CANCER CENTER

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive I1 Apr 2016MP38-14 IMPLEMENTING A MULTIMODAL PREHABILITATION PROGRAM IN A HIGH-VOLUME BLADDER CANCER CENTER Bente Thoft Jensen, Guido Dalbagni, Jørgen Bjerggaard Jensen, Caitlyn Retinger, Mallory Bowker, and Nora Love Bente Thoft JensenBente Thoft Jensen More articles by this author , Guido DalbagniGuido Dalbagni More articles by this author , Jørgen Bjerggaard JensenJørgen Bjerggaard Jensen More articles by this author , Caitlyn RetingerCaitlyn Retinger More articles by this author , Mallory BowkerMallory Bowker More articles by this author , and Nora LoveNora Love More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.118AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Radical Cystectomy (RC) is followed by a significant postoperative morbidity and complications. Enhancing an individual’s functional capacity and nutritional status before scheduled surgery; aimed at improving the patient’s tolerance to upcoming physiological stress, has been defined as prehabilitation. Evidence suggests that the preoperative period may be an opportune time to intervene and proactively involve the patients in own recovery. Thus, a higher level of implementation and experience in clinical practice of the current established evidence is warranted to secure an optimal pathway. The purpose of the study was to transfer evidence based methods of prehabilitation into clinical practice and determine feasibility, adherence and habilitation-outcome in a comprehensive cancer center. METHODS A total of 32 patients referred for RC because of bladder cancer in the period of February 2015 to August 2015 at Memorial Sloan Kettering Cancer Center were introduced to a standardized prehabilitation program. All patients underwent nutritional screening using the NRS-2002 screening tool. The physical program consisted of a general physical exercise program including the major muscle groups used for everyday activities. The resistance training was recommended with an intensity of 6-10 repetitions combined with daily aerobic activities of 30 min /day. A personal manual was given to the patients for documentation of daily achievements including recommendation of daily protein intake of minimum 1.2 g/ kg/ day and oral supplements. All patients were physical tested using the six minutes walking-test, bio-impedance and hand-grip strength at two weeks prior to surgery, day of surgery and six weeks post-surgery. RESULTS A total of 65 % [95 % confidence Interval (CI):42; 78] adhered >=75 % to the two weeks physical exercise program. The adherence to the nutritional program was 80 % [95 % CI: 62; 93] fulfilling >= 75 % of the recommendations. The six minutes walking test was significantly improved from baseline to follow up with an increase in physical capacity of 10.6 % [95% CI: 0.3; 20.99] (p=0.04). The hand-grip strength, a proxy for nutritional status, was improved 7.89 % [95 % CI:1.4:14.4] (p<0.02) from baseline to admission and maintained until follow up (p=0.47). CONCLUSIONS In a comprehensive cancer center implementing a multimodal prehabilitation program is feasible in clinical practice and proved to be supportive to maintain or even improve bodily functions post-surgery. Prehabilitation should be further explored as a potential adjuvant to improve patient’s outcomes. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e538 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Bente Thoft Jensen More articles by this author Guido Dalbagni More articles by this author Jørgen Bjerggaard Jensen More articles by this author Caitlyn Retinger More articles by this author Mallory Bowker More articles by this author Nora Love More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...