Evaluation of supervised multimodal prehabilitation programme in cancer patients undergoing colorectal resection: a randomized control trial

• Published in: Acta oncologica 2018-06, Vol.57 (6), p.1-859
• Main Authors: Bousquet-Dion, Guillaume, Awasthi, Rashami, Loiselle, Sarah-Ève, Minnella, Enrico M, Agnihotram, Ramanakumar V, Bergdahl, Andreas, Carli, Francesco, Scheede-Bergdahl, Celena
• Format: Article
• Language: English
• ISSN: 0284-186X; 1651-226X
• DOI: 10.1080/0284186X.2017.1423180

Prehabilitation has been previously shown to be more effective in enhancing postoperative functional capacity than rehabilitation alone. The purpose of this study was to determine whether a weekly supervised exercise session could provide further benefit to our current prehabilition program, when comparing to standard post-surgical rehabilitation. A parallel-arm single-blind randomized control trial was conducted in patients scheduled for non-metastatic colorectal cancer resection. Patients were assigned to either a once weekly supervised prehabilitation (PREHAB+, n = 41) or standard rehabilitation (REHAB, n = 39) program. Both multimodal programs were home-based program and consisted of moderate intensity aerobic and resistance exercise, nutrition counseling with daily whey protein supplementation and anxiety-reduction strategies. Perioperative care was standardized for both groups as per enhanced recovery after surgery (ERAS ) guidelines. Functional exercise capacity, as determined by the 6-minute walk test distance (6MWD), was the primary outcome. Exercise quantity, intensity and energy expenditure was determined by the CHAMPS questionnaire. Both groups were comparable for baseline walking capacity (PREHAB+: 448 m [IQR 375-525] vs. 461 m [419-556], p=.775) and included a similar proportion of patients who improved walking capacity (>20 m) during the preoperative period (PREHAB+: 54% vs. 38%, p = .222). After surgery, changes in 6MWD were also similar in both groups. In PREHAB+, however, there was a significant association between physical activity energy expenditure and 6MWD (p