Fit4SurgeryTV At-home Prehabilitation for Frail Older Patients Planned for Colorectal Cancer Surgery

Abstract

Objective The preoperative phase is a potential window of opportunity. Although frail elderly patients are known to be more prone to postoperative complications, they are often not considered capable of accomplishing a full prehabilitation program. The aim of this study was to assess the feasibility of Fit4SurgeryTV, an athome prehabilitation program specifically designed for frail elderly with colorectal cancer (CRC). Design The Fit4SurgeryTV program consisted of a daily elderly-adapted computer-supported strength training workout and two protein-rich meals. Frail patients 70 years with CRC were included. The program was considered feasible if 80% of the patients would be able to complete 70% of the program. Results Fourteen patients (median age 79, 5 males) participated. At baseline, 86% patients were physically impaired and 64% were at risk for malnourishment. Median duration of the program was 26 days. The program was feasible as patients followed the exercises for 6/7 (86%) days and prepared the recipes 5/7 (71%) days per week. Patients specifically appreciated at-home exercises. Conclusion This study showed that at-home prehabilitation in frail elderly with CRC is feasible. As a result, patients might be fitter for surgery and might recover faster. The perioperative period could serve as a pivotal time point in reverting complications of immobility.

Evidence on technology-driven preoperative exercise interventions: are we there yet?

“…The partial list of fascial plane blocks includes transversus abdominis plane, 6 pectoral I and II, 7 serratus anterior plane, 8,9 erector spinae plane, 10 rectus sheath, 11 quadratus lumborum, 12 and transversalis fascia blocks. 13 The fundamental problem, however, is that the notion that truncal blocks can achieve the same reliable efficacy as ultrasound-guided regional anaesthesia of the limbs neglects the essence of the latter's success: the precise administration of local anaesthetics as close as possible to the relevant nerve structures. Although some blocks of the trunk do involve nerves coming into direct contact with the local anaesthetic (e.g.…”

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“…Videoconferencing cannot replace essential hospital visits nevertheless can complement the delivery of health services and is largely accepted as an effective and non-inferior alternative to face-to-face therapy in the delivery of both postsurgical rehabilitation [14,15] and prehabilitation [17,[19][20][21]. It has further proven to be feasible and effective to deliver nutritional and psychological counseling [16,22].…”

Care of the Geriatric Colorectal Surgical Patient and Framework for Creating a Geriatric Program: A Compendium From the 2019 American Society of Colon and Rectal Surgeons Annual Meeting

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