Individualized Exercise Program Research Articles

Effect of Phentermine on Hepatic Steatosis in Bariatric Surgery: A Pilot Study

Objective: Hepatic steatosis is associated with increased surgical complications in bariatric surgery patients. We aimed to evaluate the effect of phentermine in reducing hepatic steatosis, adipose tissue, and surgical complications in patients undergoing bariatric surgery. Methods: This was a two-arm, double-blind, randomized, controlled pilot trial of 64 adult subjects with BMI >35 kg/m² selected for bariatric surgery randomized into phentermine group (15 mg once daily) or placebo group for 8 weeks. Both groups adhered to a hypocaloric diet (500 calories/day) and an individualized exercise program. The primary endpoint was reducing the frequency of hepatic steatosis measured by ultrasound and reducing adipose tissue through fat mass in total kilograms or percentage. Key secondary points were the prevalence of surgical complications. Baseline and final biochemical parameters and blood pressure too were assessments. Results: In the phentermine group, the frequency of hepatic steatosis decreased by 19%, and the percentage of patients with a normal ultrasound increased from 9% to 28% (p = 0.05). Likewise, the decrease in fat mass in kilograms was more significant in the phentermine group (56.1 kg vs. 51.8 kg, p = 0.02). A significant reduction in the HOMA-IR index was observed regardless of weight loss. No differences in surgical complications were observed between groups. Phentermine was well-tolerated; no differences were observed in the frequency of adverse events between the groups. Conclusions: Phentermine decreased the proportion of individuals with hepatic steatosis by 19% and promoted a more significant fat mass loss in kilograms among candidates for bariatric surgery.

Craving among individuals with stimulant use disorder in residential social model-based treatment – Can exercise help?

BackgroundIn a randomized controlled 8-week trial, we examined the efficacy of aerobic and resistance exercise in reducing craving for methamphetamine (MA) among individuals with MA-use disorder during residential treatment. MethodsIndividuals with MA use disorder (138) who were newly enrolled in residential treatment volunteered for random assignment to either an 8-week exercise intervention (EX) or health education control (HE), with both conditions meeting 3 times weekly; 3 dropped out of the trial, bringing the analysis sample to 135. The majority of participants were male (80%), and 48% were Latino/Hispanic. The mean age of the sample was 31.7 (SD = 6.9) years. Using multivariate mixed models, differences between conditions were examined in: (1) craving for MA, measured by self-reported ratings on a Visual Analog Scale over the 8-week trial and, (2) MA use, measured by self-report and urine drug screens at baseline and 30 and 60 days after discharge from the 8-week study. ResultsResults revealed significantly lower craving scores among the participants in the EX group than those in the HE group over the 8-week trial (median daily craving score for EX = 13.5, for HE = 21.8; p = .009). In addition, participants with less craving during treatment had significantly lower rates of MA use after discharge than participants with high craving measured at 30-days (p = .004) and 60-days post-discharge (p < .001). ConclusionsResults support the utility of incorporating a structured exercise program for individuals with MA-use disorder to reduce craving and improve MA-use outcomes.

Challenges With Strengthening Exercises for Individuals With Knee Osteoarthritis and Comorbid Obesity: A Qualitative Study With Patients and Physical Therapists.

To explore challenges associated with implementing a home-based strengthening exercise program for individuals with knee osteoarthritis and comorbid obesity. This is a qualitative study embedded within a randomized controlled trial comparing 2 home-based strengthening programs (weight-bearing functional exercise versus non-weight-bearing quadriceps strengthening exercise) for individuals with knee osteoarthritis and comorbid obesity. Patients in both exercise programs attended 5 consultations with a physical therapist and undertook a home-based exercise program for 12 weeks. After trial completion, semistructured individual telephone interviews were conducted with 22 patients and all 7 physical therapists who delivered trial interventions. Interviews were recorded, transcribed verbatim, and thematically analyzed using an inductive approach. Three themes arose: 1) psychological challenges (false assumptions about exercise; fear of pain; disliking exercise; mental effort of the weight-bearing functional program; underestimating capability); 2) physical challenges (complexity of the weight-bearing functional program; cuff weights and straight leg raise being problematic in non-weight-bearing quadriceps program; other health conditions); and 3) overcoming challenges (incentives to exercise; accountability; education and reassurance; tailoring the exercise program). Patients and physical therapists experienced numerous psychological and physical challenges to exercise, including a fear of pain, having false assumptions about exercise, difficulties with exercise performance, application of cuff weights, and adverse impacts of other health conditions.

A Brief, Individualized Exercise Program at Intensities Below the Ventilatory Threshold Exerts Therapeutic Effects for Depression: A Pilot Study.

Due to the fact that existing pharmacological treatments for depression are not ideal, effort has been devoted to the development of complementary, alternative therapies such as physical exercise. The antidepressant effect of exercise is well documented. However, current recommendations and prescriptions of exercise may be too demanding for depressed patients, as some complain about the design of exercise programs and depression is associated with reduced motivation and capacity to exercise. Therefore, appropriately designed, patient-friendly exercise programs may prove critical for the long-term maintenance and therapeutic effects of exercise. In this pilot study, we developed an exercise program based on patients’ individual level of ventilatory threshold (VT), a submaximal index of aerobic capacity measured by Cardiopulmonary Exercise Testing (CPX). Compared to traditional measures, CPX provides more trustable indices of aerobic capacity and more homogenous exercise prescriptions. The main episode of the program consisted of 15–25 min of cycling twice a week at an intensity that approached but never went higher than subjects’ VT (considered low to moderate in intensity). We found that in patients diagnosed with major depressive disorder or persistent depressive disorder (n = 8), the program resulted in a significant reduction in depressive symptoms at week 8, which was maintained at week 16. Meanwhile, patients’ social functioning, quality of life, and cognitive functions improved. Although we used a single arm, non-randomized design, our results suggest that even a brief, low to moderate intensity exercise program may exert therapeutic effects for depression and CPX may be a useful tool for exercise prescriptions.

Moving Past the One-Size-Fits-All Education-Training Model of Police Academies to the Self-Prescribed Individualized Exercise Prescription Model.

Law enforcement agencies generally employ the “one-size-fits-all” education-training model. Its effectiveness compared to alternative training models has been under scrutiny. Physical fitness scores of Serbian male (n = 98) and female (n = 79) police cadets during their yearly evaluation were compared. Cadets trained for the first 3 years with the “one-size-fits-all” model. In the fourth year, they self-prescribed an individualized exercise program based on the obtained curriculum knowledge. A two-way MANOVA revealed a significant effect of academic years on combined variables (p < 0.001) and significant differences between academic years for deadlift, half squat, standing long jump, sit-ups and 12-min Cooper test time (p < 0.001). Sex also had a significant main effect on combined variables (p < 0.001) with males outscoring females on all of the fitness assessments. For pull-ups, there was a significant year * sex interaction (p = 0.01) with the third year to be pivotal for female and male performance, respectively. In conclusion, the use of a “one-size-fits-all” model, presented differences in physical fitness scores between the years one to three, pointing to its questionable effectiveness. On the contrary, the self-prescribed individualized exercise program of the fourth year elicited greater fitness scores, indicating the need to evaluate the applicability of such a training model more.

The Incremental Shuttle Walk Test

The Incremental Shuttle Walk Test

The utilization of dry needling and an upper extremity exercise program for individuals with cervicogenic headaches: A pilot study

ABSTRACT Objective To investigate whether a combination of dry-needling treatments and upper extremity neuromuscular reeducation exercises can significantly improve neck pain and/or headache-related disability, joint position error, cervical range of motion, and pain pressure threshold in individuals suffering from cervicogenic headache (CGH). Methods This study is a quasi-experimental design. Seven participants met the inclusion criteria and received dry needling to three muscles that reproduced the participant’s headache symptoms and completed the Neck Disability Index (NDI), Headache Disability Inventory (HDI), Visual Analog Scale (VAS), and Numeric Pain Rating Scale (NPRS). Participants performed an exercise regimen designed to address strength and mobility of cervical and scapulothoracic musculature. Results There were significant improvements seen in cervical range of motion and neck pain-related disability (NDI) during the 4-week treatment period. Conclusion Dry needling and neuromuscular re-education (NMR) exercises could be effective components of treatment for individuals suffering from CGH to reduce disability and pain.

A feasibility pilot- a personalised physiotherapy led remote ACHD cardiac rehabilitation program

ObjectiveTo determine the feasibility of physiotherapy led remote cardiac rehabilitation (RCR) for Adult Congenital Heart Disease (ACHD) patients and quantify the impact on physical activity levels and well-being. MethodACHD cardiologists referred sedentary complex ACHD patients over 3 months, for 12-week physiotherapy-led RCR. RCR provided individualised exercise program and coaching via telephone clinics and apps. Outcomes in Self Efficacy for Exercise (SEE) and Satisfaction with Life Score (SWLC) were assessed by comparing patients' responses upon program completion to baseline. Results23 patients were referred, 11 completed the programme, 3 had learning difficulties. Participants were mainly female (9); age range 18–61 (median 24). Reasons for not completing RCR included; failure to attend initial appointments (7), lack of interest (1), too unwell (1), lost at follow up (1) and a death unrelated to RCR.Initially no patients were achieving the UK Physical Activity Guidelines; all 11 became more active fulfilling the guidelines. Improvements were seen in SEE with a mean increase of 23 (SD 12) and a mean improvement of 10 (SD 4) in SWLC. Participants (9) responded well to apps. Reasons for not using apps included limited phone storage capacity to download the app (1) or lack of device (2). Patients found RCR acceptable and a personalised approach was essential to improving efficacy. ConclusionRCR is feasible, allowing patients to access specialised, personalised exercise advice and prescription and become more active, improving quality of life (QOL). Future work is required to improve uptake and extend to larger patient numbers.

A long-term community gym program for people with Parkinson’s disease: a feasibility study of the Monash Health “Health and Fitness” model

Purpose To investigate the feasibility and acceptability of the Health and Fitness Program (HFP), a long-term community gym program for people with mild to moderate Parkinson’s disease (PD). Methods Physiotherapists, with PD expertise, developed individualised exercise programs for new HFP members in consultation with them. Gym instructors, with PD training, supervised the HFP sessions. Exercises included progressive strength training, aerobic, balance, and stretching. Participants who had been enrolled in the HFP for 12 months, were recruited to a single group pre/post design study to test the program’s feasibility and acceptability. Feasibility included safety, retention, attendance, and compliance data and acceptability measured using a customised questionnaire. Results 17 of the 20 HFP members enrolled maintained membership for 12 months and participated in this study. The program was shown to be feasible with no falls reported during sessions, only one participant reported pain from exercising lasting more than 48 h, retention was high (85%) and most members complied with their program. Overall satisfaction with the program was high, with seven somewhat satisfied and 10 very satisfied. Conclusion The HFP demonstrated that a PD community gym program is feasible and acceptable when physiotherapists and PD-trained instructors collaborate to provide individualized exercise programs. IMPLICATIONS FOR REHABILITATION People with Parkinson’s disease need support to maintain long-term adherence to regular exercise which can be achieved with supervised community-based gym programs. A community-based PD-specific exercise program can be safe and acceptable to people with PD when PD specialist physiotherapists are involved in planning participants’ exercise programs and PD-trained gym instructors supervise the exercise sessions. Members are satisfied with programs that have strategies in place to minimise barriers to participation, such as keeping costs to members low, providing a quality service, having supportive trained staff, and creating opportunities for social interaction between members. Evidence-based community exercise programs may result in improved strength and aerobic fitness and maintain quality of life in people with mild to moderate PD however further research using an RCT study is needed.

Adherence Rate, Barriers to Attend, Safety, and Overall Experience of a Remote Physical Exercise Program During the COVID-19 Pandemic for Individuals After Stroke.

Introduction: The actions taken by the government to deal with the consequences of the coronavirus diseases 2019 (COVID-19) pandemic caused different levels of restriction on the mobility of the population. The need to continue offering physical exercise to individuals after stroke became an emergency. However, these individuals may have barriers to adhere to the programs delivered remotely. There is a lack of evidence related to adherence, attendance, safety, and satisfaction of remote exercise programs for this population.Objective: The aim was to evaluate adherence and barriers to attend a remote physical exercise program for individuals after stroke. We aimed (a) to identify adherence and attendance rate of the remote physical exercise program (i.e., number of participants engaged, number of sessions attended, and exercise time in remote program); (b) to identify the safety of a remote physical exercise program (i.e., falls, pain, or dizziness when performing the exercises, fear, or insecurity); and (c) to identify the overall experience to participate in a remote program.Materials and methods: This is a longitudinal study, including 36 stroke survivors who already attended a face-to-face physical exercise program prior to the COVID-19 pandemic. The remote physical exercise program included sessions for 2 days/week for a duration of 22 weeks, with a total of 44 sessions, which were delivered asynchrony via recorded video sessions. As outcome measures, we performed two questionnaires (via weekly telephone calls) to identify attendance, barriers, safety, and overall experience related to the program.Results: The adherence rate was 86 (9%). The attendance rate was 19, with a total of 8 sessions (108.3 min/week). The main barriers for lower attendance rate were as follows: lack of motor skills and physical fitness to workout in 80 reports (20.6%), followed by no exercise companion in 44 reports (11.3%). The remote physical program has been shown to be safe, and the overall experience was positive from the perspectives of the participants and the family members.Conclusion: Although the adherence rate was high, the attendance rate was low on the remote physical exercise program. The main barriers to attending the program remotely reflect the need of tailoring individually an asynchrony mode of delivering the sessions to individuals after stroke. Our results also indicate how the COVID-19 impacted the health conditions of stroke survivors. The program was safe, and the overall experience indicated a change in the mental, physical, and social health of individuals after stroke and their family members.

Variability in physical function for patients living with breast cancer during a 12-week exercise program

To describe the variability during weekly performance on physical function tests during a 12-week individualized exercise program for patients with breast cancer and to test if the expected improvements in physical function surpass the minimally clinically important difference (MCID), after accounting for week-to-week variance. Twenty-five participants, 19years and older living with breast cancer within 2years of their initial diagnosis, were recruited. Some participants were undergoing active treatment, while others completed their treatment. The intervention was an individualized exercise session twice a week, for 1h each session, for a total of 12weeks. Main outcomes tested included the 6-min walk test and chair stand test. A significant average improvement was observed in the 6MWT (p < .01) and the chair stand test (p < .001) following the intervention. Individual confidence intervals were wide across all testing measures with only 28% and 8% of participants meeting or surpassing the MCID for the 6MWT and chair stand test, respectively. Despite a significant improvement in physical function during the program, the majority of patients did not reach the MCID, which could be due to large variability resulting from treatment-related side effects or measurement error.

Improvement of physical activity levels in children and adolescents after surgery for congenital heart disease: preferences and use of physical therapy

Purpose After surgery for congenital heart disease in children and adolescents, an active lifestyle is important to achieve and maintain good physical fitness. This study aimed to describe physical activity, as well as the use of patients’ and parents’ preferences for rehabilitative care after surgery for congenital heart disease. Methods This cross-sectional study included patients aged 4–16 years old, who had undergone surgery for congenital heart disease 2 years prior to the study onset. Patients and/or parents were invited to complete questionnaires on physical activity, and on their preferences for, and -use of, rehabilitative care after surgery. Results Forty-five of the 92 eligible patients and/or parents completed the questionnaires. The median age of the children was 12.2 years (IQR 7.8–16.1). Two children (4%) met the recommendations for taking part in moderate physical activity and 13 (29%) having done so for vigorous physical activity. Postoperatively 15 children (33%) had had physical therapy in primary care. More than 50% of the patients/parents would have preferred to have had more information on physical activity and to have taken part in an individual exercise program delivered during their primary care. Conclusion The majority of eligible patients do not meet public health recommendations for engaging in physical activity and do not use physical therapy after surgery for congenital heart disease. The majority of patients and parents preferred more information as well as individual physical therapy treatments. Implications for rehabilitations Two years after surgery for congenital heart disease children and adolescents are less active compared to typically developing peers. Patients with a congenital heart disease and their parents need more information and support regarding stimulation of physical activity and physical fitness after heart surgery. In the postoperative process, a well-structured and supportive (individual) rehabilitation program should be introduced to improve physical activity and physical fitness.

Measuring the Feasibility and Effectiveness of an Individualized Exercise Program Delivered Virtually to Cancer Survivors.

In the spring of 2020, we faced a global pandemic that resulted in social distancing limitations not previously experienced, forcing practitioners to adapt exercise programming to a virtual model. The purpose of this investigation was to measure the effectiveness of a virtual exercise oncology program in 491 participants undergoing antineoplastic therapy between March and June 2020. Each session was completed virtually with a certified exercise oncology trainer. Fitness and psychological parameters were measured preexercise and postexercise intervention. Overall, participants completed 4949 of 5892 prescribed exercise sessions. Patients saw increases in cardiovascular endurance (15.2%, P < 0.05), muscular endurance (18.2%, P < 0.05), flexibility (31.9%, P < 0.05), feelings of support (58.7%, P < 0.05), and quality of life (32.2%, P < 0.05), as well as decreases in loneliness (54%, P < 0.05) and fatigue (48.7%, P < 0.05). In light of our findings, we assert that virtual exercise training is a viable option in circumstances where in-person, individualized exercise training is not possible.

Red Blood Cell Distribution Width Trajectory During a Multicomponent Exercise in Hospitalized Older Adults: A Secondary Analysis of a Randomized Clinical Trial.

There is emerging evidence that emphasizes RDW as an optimal prognostic biomarker for cardiovascular diseases (Rejuvenation Research: https://pubmed.ncbi.nlm.nih.gov/30572793/ https://pubmed.ncbi.nlm.nih.gov/30132390/). However, there is hardly any evidence of interventions that are capable of modifying RDW. Our aim was to investigate the association of RDW levels and the response to an individualized exercise program in hospitalized older adults. To our knowledge, this is the first study that specifically looks at the impact of an intervention in this parameter among very old hospitalized patients. We have failed to show any change, but we consider that this result is also important in order to continue with the research of the strong correlation of RDW and different biological pathways.

Usefulness of a hand therapy application

Study DesignCross-sectional cohort design that collected data by means of a survey. IntroductionPerformance and adherence to a home exercise program (HEP) has been identified as an integral component of hand therapy rehabilitation. Understanding how patients learn along with offering creative options to improve engagement is important. Advancements in technology including the use of smart phone apps should be considered. Purpose of StudyTo determine if a hand therapy app is a useful method for patient education and home exercises for patients receiving hand therapy for an orthopedic injury distal to the shoulder. MethodIndividuals receiving hand therapy at an outpatient hand therapy clinic via a convenience sample (n = 41) were asked to download use The Hand Therapy Application for an individualized exercise program. The Mobile Application Rating Scale (MARS) questionnaire was used to assess the smart phone app. ResultsThe overall MARS score for the hand therapy app was 3.5 out of 5. The MARS also gathered information on the app's engagement, functionality, aesthetics, and subjective quality of the app with mean scores of 3.6, 3.8, and 3.7, respectively. Data was also collected on the app's description accuracy, goals, quality and quantity of information, visual information, credibility, and evidence base. DiscussionParticipants receiving skilled hand therapy gave an overall rating of The Hand Therapy Application as above average for providing information about the participants condition and for HEP instruction. ConclusionThe findings of this study suggests that The Hand Therapy Application should be a consideration as a HEP tool in clinical practice.

Exercise as a Therapeutic Intervention in Gestational Diabetes Mellitus.

Gestational Diabetes Mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. Regular exercise is important for a healthy pregnancy and can lower the risk of developing GDM. For women with GDM, exercise is safe and can affect the pregnancy outcomes beneficially. A single exercise bout increases skeletal muscle glucose uptake, minimizing hyperglycemia. Regular exercise training promotes mitochondrial biogenesis, improves oxidative capacity, enhances insulin sensitivity and vascular function, and reduces systemic inflammation. Exercise may also aid in lowering the insulin dose in insulin-treated pregnant women. Despite these benefits, women with GDM are usually inactive or have poor participation in exercise training. Attractive individualized exercise programs that will increase adherence and result in optimal maternal and offspring benefits are needed. However, as women with GDM have a unique physiology, more attention is required during exercise prescription. This review (i) summarizes the cardiovascular and metabolic adaptations due to pregnancy and outlines the mechanisms through which exercise can improve glycemic control and overall health in insulin resistance states, (ii) presents the pathophysiological alterations induced by GDM that affect exercise responses, and (iii) highlights cardinal points of an exercise program for women with GDM.

Longitudinal Examination of Leisure-Time Physical Activity (LTPA), Participation, and Social Inclusion Upon Joining a Community-based LTPA Program for Adults With Physical Disabilities

ObjectiveFirst, to examine whether participants reported changes in (1) leisure-time physical activity (LTPA) participation and social inclusion variables and (2) well-being outcomes before and after joining a community-based LTPA program for adults with physical disabilities. Second, to explore the longitudinal relationship between LTPA and the other aforementioned outcomes. DesignA double baseline longitudinal design with measurements at 4-6 weeks (baseline 1) and immediately (baseline 2) before and 2 and 4 months after joining the community-based LTPA program. SettingCommunity. ParticipantsAdults (N=43) with a physical disability who reported no cognitive impairment, were new members of the community-based LTPA program, and spoke English or French. InterventionsA community-based physical activity program for adults with physical disabilities. Participants were provided an individualized exercise program and accessed the program at designated times during the week. Main Outcome MeasuresPrimary: LTPA (LTPA Questionnaire for People with Spinal Cord Injury), participation (Patient-Perceived Participation in Daily Activities Questionnaire), and social inclusion. Secondary: depression severity, self-esteem, resilience, and life satisfaction. ResultsAfter joining the program, participants reported an increase in total LTPA (meanbaseline2, 177.80±211.32; mean2months, 299.31±298.70; mean4months, 288.14±292.14), moderate-to-vigorous LTPA (meanbaseline2, 83.95±123.95; mean2months, 142.00±198.38; mean4months, 163.23±182.08), and participation in health (meanbaseline2, 6.24±1.16; mean2months, 6.58±1.25; mean4months, 6.97±0.82) and family-related activities (meanbaseline2, 12.18±2.43; mean2months, 12.60±2.30; mean4months, 13.47±2.01). A significant increase (β=3.46, P<.001) in social inclusion before joining the program was followed by a decrease (β=−1.09, P<.05) 4 months later. Improvements related to depression severity were noted (βbaseline1−baseline2=−1.51, P<.05; βbaseline2−4 months=−0.28, P>.05). ConclusionsThe results support the role of a community-based LTPA program in increasing LTPA levels and enhancing participation in some activities among adults with physical disabilities.

Recovery of the Decline in Activities of Daily Living After Hospitalization Through an Individualized Exercise Program: Secondary Analysis of a Randomized Clinical Trial.

During the period of hospitalization, patients can develop functional decline. The main aim of our study was to assess the natural trajectory of each activity of daily living (ADL) and to assess how in-hospital exercise could influence short-term trajectory of ADLs. Acutely hospitalized patients (n = 297, 56.5% women) were randomly assigned to the intervention or control (usual care) group within the first 48 hours of admission. An exercise training program was prescribed in 2 daily sessions (morning and evening) of 20 minutes duration during 5-7 consecutive days for the intervention group. The primary endpoint was the change in every ADL (assessed with the Barthel Index) from 2 weeks before admission to hospital discharge. Acute hospitalization per se led to significant in-patient's functional ability impairment in ADLs during hospitalization, whereas the exercise intervention reversed this trend (3.7 points; 95% CI: 0.5-6.8 points). After analyzing the trajectory of each one of the ADLs, patients in the control group significantly worsened all activities, but with a different degree of loss. For the between-group analysis, significant differences were obtained in many ADLs including bathing, dressing, grooming, bladder control, toilet use, transfers, mobility, and climbing stairs (p < .05). The control group had the greatest impairment in all domains analyzed (ie, feeding, bathing, dressing, grooming, bowel control, bladder control, toilet use, transfers, mobility, and climbing stairs; p < .05). An individualized multicomponent exercise training program in older adults is effective to reverse the loss of specific ADLs that frequently occurs during hospitalization. Each patient profile should receive an individualized prescription of exercise during hospitalizations. NCT02300896.

Lifestyle Intervention in Chronic Ischaemic Heart Disease and Type 2 Diabetes (the LeIKD study): study protocol of a prospective, multicentre, randomised, controlled trial

IntroductionGuidelines recommend lifestyle intervention in chronic ischaemic heart disease (CIHD) and type 2 diabetes mellitus (T2DM). However, evidence from randomised controlled trials is scarce in patients with combined entities.Methods and...

Feasibility and acceptability of a preoperative exercise program for patients undergoing major cancer surgery: results from a pilot randomized controlled trial

ObjectiveTo establish the feasibility and acceptability of a preoperative exercise program, and to obtain pilot data on the likely difference in key surgical outcomes to inform the sample size calculation for a full-scale trial.DesignPilot randomized controlled trial.SettingRoyal Prince Alfred Hospital, Sydney, Australia.SubjectsWe included patients undergoing elective pelvic exenteration or cytoreductive surgery aged 18 to 80 years, who presented to the participating gastrointestinal surgeon at least 2 weeks prior to surgery. Patients presenting cognitive impairment, co-morbidity preventing participation in exercise, inadequate English language, currently participating in an exercise program or unable to attend the exercise program sessions were excluded.MethodsParticipants were randomized to a 2–6 weeks preoperative, face-to-face, individualised exercise program or to usual care. Feasibility was assessed with consent rates to the study, and for the intervention group, retention and adherence rates to the preoperative exercise program. Acceptability of the exercise program was assessed with a semi-structured questionnaire exploring the advice received and the amount, duration and intensity of the exercise program. In addition, postoperative complication rates (Clavien-Dindo), length of hospital stay and self-reported measures of health-related quality of life (SF-36v2) were collected at baseline, day before surgery and in-hospital up to discharge from hospital.ResultsOf 122 patients screened, 26 (21%) were eligible and 22 (85%) accepted to participate in the trial and were randomized to the intervention (11; 50%) or control group (11; 50%). The median age of the include participants was 63 years. Adherence to the preoperative exercise sessions was 92.7%, with all participants either satisfied (33%) or extremely satisfied (67%) with the overall design of the preoperative exercise program. No significant differences in outcomes were found between groups.ConclusionsThe results of our pilot trial demonstrate that a preoperative exercise program is feasible and acceptable to patients undergoing major abdominal cancer surgery. There is an urgent need for a definite trial investigating the effectiveness of a preoperative exercise program on postoperative outcomes in patients undergoing major abdominal cancer surgery. This could potentially reduce postoperative complication rates, length of hospital stay and subsequently overall health care costs.Trial registrationACTRN12617001129370. Registered on August 1, 2017, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373396&showOriginal=true&isReview=true