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This study aimed to see if improved functional capacity (as evaluated by walking performance) prior to colorectal surgery for cancer impacted 30 day post-op complications and emergency room visits. Eighty patients who significantly improved their walking performance before surgery were compared to ninety nine who did not. Those who improved their walking had lower post-op complication rates, less severe complications, and were less likely to visit the emergency room after surgery.
The impact of improved functional capacity before surgery on postoperative complications: a study in colorectal cancer
2019
Acta Oncologica
Observational Study
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This unique study in elderly colorectal cancer patients compared the effects of a comprehensive combined pre- and post-op care program to standard care. The 'prehab' section of the program included supervised and home-based resistance and endurance exercise done twice a week for 4-6 weeks, a nutritional assessment with protein supplementation, and mental health counselling. Following surgery, a similar 'rehab' program was completed as necessary until patients were self-supporting at home. Compared to the standard care group, there was a reduction in 1-year mortality rates in the intervention group compared to standard care but this did not reach statistical significance (p=0.08). The most interesting part of this study was the division of the control group into 2 cohorts, the later cohort occurring during the development of the program (you will need to read the study to understand this!) Dedicated multidisciplinary care alone (without the prehab and rehab) seemed to provide benefit to this elderly population.
Comprehensive multidisciplinary care program for elderly colorectal cancer patients: "From prehabilitation to independence"
2018
European Journal of Surgical Oncology
Observational Study
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The goal of this study was to determine if the addition of a weekly supervised exercise session to a well established unsupervised multimodal prehab program would further improve outcomes. The study compared a Prehab+ program (N=41) with a Rehab program (N=39) in elderly colorectal cancer patients. The Prehab+ group received a multimodal prehab program supplemented with 1 supervised exercise session per week before surgery .The Rehab group, in contrast, did the identical program (minus the supervised session) following surgery. At 8 weeks post-surgery, both groups improved their walking capacity to a similar level. Sedentary patients seemed more likely to benefit from the Prehab+ program.
Evaluation of supervised multimodal prehabilitation programme in cancer patients undergoing colorectal resection: a randomized control trial
2018
Acta Oncologica
RCT
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This randomized controlled trial examined if nutritional and exercise prehab training for patients with obesity (BMI 30-40) undergoing ventral hernia repair would result in fewer complications and more successful surgeries compared to standard counselling. They found that after 6 months of training, the 59 prehab patients were more likely to achieve weight loss goals with fewer complications than the 59 patients receiving standard counselling.
Modifying Risks in Ventral Hernia Patients With Prehabilitation: A Randomized Controlled Trial
2018
Annals of Surgery
RCT
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This study investigated the impact of a 6-week exercise prehabilitation program in addition to standard care on adults over age 70 preparing for major abdominal surgery. The standard care group (N=63) received nutritional counselling +/- intervention, physical activity and health advice, and iron injections if deficient. The prehab group (N=62) received the same care plus a personalized exercise program aimed at increasing physical activity levels, motivating patients to move more, and engaging them in supervised high-intensity endurance training. No specific strength training program was mentioned. After surgery, the prehab group had a significantly lower rate of complications (31%) compared to the standard care group (62%). The authors suggest that this reduction in complications may be due to the increased exercise capacity seen in the prehab group after the training program.
Personalised Prehabilitation in High-risk Patients Undergoing Elective Major Abdominal Surgery: A Randomized Blinded Controlled Trial
2018
Annals of Surgery
RCT
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This feasibility RCT in men requiring a radical prostatectomy patients compared an exercise-based prehab program (N=44) to usual care (N=42). The prehab group were given exercise equipment and completed an individualised, home-based aerobic and resistance exercise program 3-4 times per week. Both groups also did pelvic floor muscle-strengthening exercises. 69% of prehab patients met the exercise program's adherence rate, while 37% and 39% of prehab and usual care patients, respectively, met the pelvic floor program's adherence level. At 4 weeks post-op, prehab patients had significantly better functional walking capacity. Prehab patients also showed higher grip strength and reduced anxiety levels before and 26 weeks after surgery. No differences were found in complication rates or hospital length of stay duration.
Prehabilitation for radical prostatectomy: A multicentre randomized controlled trial
2018
Journal of Surgical Oncology
Pilot Study
Physical activity levels in locally advanced rectal cancer patients following neoadjuvant chemoradiotherapy and an exercise training programme before surgery: a pilot study
2017
Perioperative Medicine
Pilot Study
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This RCT tested whether a cognitive training technique called the "Method of Loci" could help reduce risk for postoperative cognitive dysfunction (POCD) in elderly patients (mean age 70) undergoing gastrointestinal surgery. This training technique involves visualizing images and associating them with words to aid in remembering a list of items. It was found that POCD was significantly lower (15.9%) following cognitive prehab compared to those without training (36.1%). Other domains of thinking also improved.
Preoperative cognitive intervention reduces cognitive dysfunction in elderly patients after gastrointestinal surgery: a randomized controlled trial
2015
Medical Science Monitor
RCT
Preoperative therapeutic programme for elderly patients scheduled for elective abdominal oncological surgery: a randomized controlled pilot study
2010
Clinical Rehabilitation
Pilot Study
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