Abstract

BackgroundPre‐operative cardiorespiratory fitness (CRF) in colorectal cancer (CRC) patients has been shown to affect post‐operative outcomes. The aim of this study was to test the feasibility of high‐intensity interval training (HIIT) for improving fitness in pre‐operative CRC patients within the 31‐day cancer waiting‐time targets imposed in the UK.MethodsEighteen CRC patients (13 males, mean age: 67 years (range: 52‐77 years) participated in supervised HIIT on cycle ergometers 3 or 4 times each week prior to surgery. Exercise intensity during 5 × 1‐minute HIIT intervals (interspersed with 90‐second recovery) was 100%‐120% maximum wattage achieved at a baseline cardiopulmonary exercise test (CPET). CPET before and after HIIT was used to assess CRF.ResultsPatients completed a mean of eight HIIT sessions (range 6‐14) over 19 days (SD 7). There was no significant increase in VO2 peak (23.9 ± 7.0 vs 24.2 ± 7.8 mL/kg/min (mean ± SD), P = 0.58) or anaerobic threshold (AT: 14.0 ± 3.4 vs 14.5 ± 4.5 mL/kg/min, P = 0.50) after HIIT. There was a significant reduction in resting systolic blood pressure (152 ± 19 vs 142 ± 19 mm Hg, P = 0.0005) and heart rate at submaximal exercise intensities after HIIT.ConclusionsOur pragmatic HIIT exercise protocol did not improve the pre‐operative fitness of CRC patients within the 31‐day window available in the UK to meet cancer surgical waiting‐time targets.

Highlights

  • There is a growing body of evidence that objective measures of pre‐operative cardiorespiratory fitness (CRF) correlate with post‐operative outcomes following elective colorectal cancer (CRC) surgery[1,2,3] and that threshold variables exist for cardiopulmonary exercise testing (CPET, the “gold‐standard” text of cardiorespiratory fitness4) below which complications are more likely to occur.[5]

  • |2 oxygen consumption (VO2 peak: the peak value for oxygen consumption by an individual during a period of exercise) and anaerobic threshold (AT: the point at which, during increasing work, the aerobic metabolism of an individual is supplemented by the anaerobic metabolism to produce cellular energy6)

  • Exercise training is well known to improve CRF in a variety of healthy and clinical cohorts,[7] and has the potential to move people away from these “at‐risk” thresholds, it is not yet known whether this can be achieved by CRC patients within the maximum 31‐day target time frame available in the UK between decision to treat and operation.[8]

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Summary

Introduction

There is a growing body of evidence that objective measures of pre‐operative cardiorespiratory fitness (CRF) correlate with post‐operative outcomes following elective colorectal cancer (CRC) surgery[1,2,3] and that threshold variables exist for cardiopulmonary exercise testing (CPET, the “gold‐standard” text of cardiorespiratory fitness4) below which complications are more likely to occur.[5]. Exercise training is well known to improve CRF in a variety of healthy and clinical cohorts,[7] and has the potential to move people away from these “at‐risk” thresholds, it is not yet known whether this can be achieved by CRC patients within the maximum 31‐day target time frame available in the UK between decision to treat and operation.[8]. The aim of this study was to test the feasibility of high‐intensity interval training (HIIT) for improving fitness in pre‐operative CRC patients within the 31‐day cancer waiting‐time targets imposed in the UK. Conclusions: Our pragmatic HIIT exercise protocol did not improve the pre‐operative fitness of CRC patients within the 31‐day window available in the UK to meet cancer surgical waiting‐time targets

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