Home-based prehabilitation improves physical conditions measured by ergospirometry and 6MWT in colorectal cancer patients: a randomized controlled pilot study

Abstract

Purpose/ BackgroundPrehabilitation aims to improve physical condition in the preoperative period and, therefore, decrease the loss of cardiopulmonary capacity postoperatively, with the aim of reducing complications and promoting an early recovery. This study aims to evaluate the impact of home-based prehabilitation on the physical condition of patients treated surgically for colorectal cancer. MethodsA prospective and randomized clinical study was conducted in 60 patients during two periods, October 2018 -September 2020, in a single university hospital. Patients were randomized into two study groups (30 per group): prehabilitation vs standard care. Changes in physical condition, measured at diagnosis, the day before surgery, and at 6-8 weeks after surgery using Cardiopulmonary Exercise Test (CPET) and the 6-minute walk test (6MWT) were evaluated. ResultsPrehabilitation reduce postoperative complications (17.4% vs 33.3%, p=0.22) and hospital stay (5.74 vs 6.67 days, p=0.30). 6MWT showed a signi cant improvement in prehabilitation group (+78.9 meters). Six weeks after surgery, prehabilitation showed a signi cant improvement in the 6MWT (+ 68.9 meters vs -27.2 meters, p=0.01). Signi cant differences were also observed in the ergospirometry between the diagnosis and postoperative study (+ 0.79 METs vs -0.84 METs, p=0.001). A strong correlation was observed between CPET and 6MWT (0.767 (p<0.001)). ConclusionHome prehabilitation achieved lower overall postoperative complications than standard care and reached signi cant improvements in 6MWT and CET. Strong correlation was observed between CET and 6MWT, which allows validation 6MWT as a valid and reliable measure of functional exercise capacity in colorectal patiens when other more speci c and expensive tests are not available. Registration numberRegistered in ClinicalTrials.gov in August 2018 with registration number NCT03618329. Initial results published in Supportive Care in Cancer:Effect of home-based prehabilitation in an enhanced recovery after surgery program for patients undergoing colorectal cancer surgery during the COVID-19 pandemic.

Prehabilitation in Adults Undergoing Cancer Surgery: A Comprehensive Review on Rationale, Methodology, and Measures of Effectiveness

“…Perhaps the biggest challenge in ascertaining its effectiveness is the large variability of interventions, schedules, durations, and modalities. More recently, several clinical trials evaluating prehabilitation in cancer surgery have been published [16][17][18]. This study follows the recommendations of the SANRA scale for narrative reviews [19].…”