Multiphasic Prehabilitation Across the Cancer Continuum: A Narrative Review and Conceptual Framework

Mina, Daniel Santa; Rooijen, Stefanus J. van; Minnella, Enrico Maria; Alibhai, Shabbir M.H.; Brahmbhatt, Priya; Dalton, Susanne Oksbjerg; Gillis, Chelsia; Grocott, Michael P.W.; Howell, Doris; Randall, Ian; Sabiston, Catherine M.; Silver, Julie K.; Slooter, Gerrit D.; West, Malcolm; Jack, Sandy; Carli, Franco

doi:10.3389/fonc.2020.598425

Cited by 60 publications

(51 citation statements)

References 90 publications

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“…The introduction of the Health-Circuit approach will facilitate a "connected experience" for both the patient and the healthcare professionals fostering engagement into the care management process. Moreover, this proposal has the potential to be adopted by programs supporting long-term management of cancer patients (17) and chronic patients, as well as prevention of multimorbidity in subjects at risk. The final milestone would be the optimization of long-term self-management programs with proven health value generation.…”

Section: Introductionmentioning

confidence: 99%

Digital Support to Multimodal Community-Based Prehabilitation: Looking for Optimization of Health Value Generation

et al. 2021

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Prehabilitation has shown its potential for most intra-cavity surgery patients on enhancing preoperative functional capacity and postoperative outcomes. However, its large-scale implementation is limited by several constrictions, such as: i) unsolved practicalities of the service workflow, ii) challenges associated to change management in collaborative care; iii) insufficient access to prehabilitation; iv) relevant percentage of program drop-outs; v) need for program personalization; and, vi) economical sustainability. Transferability of prehabilitation programs from the hospital setting to the community would potentially provide a new scenario with greater accessibility, as well as offer an opportunity to effectively address the aforementioned issues and, thus, optimize healthcare value generation. A core aspect to take into account for an optimal management of prehabilitation programs is to use proper technological tools enabling: i) customizable and interoperable integrated care pathways facilitating personalization of the service and effective engagement among stakeholders; ii) remote monitoring (i.e. physical activity, physiological signs and patient-reported outcomes and experience measures) to support patient adherence to the program and empowerment for self-management; and, iii) use of health risk assessment supporting decision making for personalized service selection. The current manuscript details a proposal to bring digital innovation to community-based prehabilitation programs. Moreover, this approach has the potential to be adopted by programs supporting long-term management of cancer patients, chronic patients and prevention of multimorbidity in subjects at risk.

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Section: Introductionmentioning

confidence: 99%

Digital Support to Multimodal Community-Based Prehabilitation: Looking for Optimization of Health Value Generation

et al. 2021

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“…Surgical prehabilitation in oncology patients is further complicated by neoadjuvant therapies, such as chemotherapy and radiation. These therapies may contribute to further deconditioning and poor nutritional status from which patients may not have sufficient time for recovery before surgery, placing them at greater risk for postoperative complications [ 65 ]. This was seen in a study by West et al [ 66 ] that showed that neoadjuvant chemoradiotherapy reduced physical fitness in patients with rectal cancer.…”

Section: Clinical Considerationsmentioning

confidence: 99%

Brain Prehabilitation for Oncologic Surgery

et al. 2022

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Purpose of Review This review aims to summarize the current research on postoperative cognitive complications, such as delirium and cognitive dysfunction. This includes discussion on preoperative preventive strategies, such as physical and nutritional prehabilitation as well as up-to-date information on neuroprehabilitation. Recent Findings Current recommendations for prevention of postoperative delirium have focused on multicomponent interventions. The optimal composition of surgical prehabilitation programs targeting exercise and nutrition has not yet been established. The Neurobics Trial shows that cognitive prehabilitation improves cognitive reserve and may be a useful addition to multimodal surgical prehabilitation. Summary Perioperative management of oncologic patients is often associated with a myriad of challenges, such as the management of tumor-related pathologies, adverse events from neoadjuvant therapy, and chronic metabolic and immunological changes associated with malignancy. In addition, oncologic patients are at increased risk of developing frailty, which adversely affects postoperative recovery and further cancer treatment. As a result, oncologic patients are at considerable risk of developing postoperative cognitive complications, such as delirium and cognitive dysfunction. In this review, we discuss the effect of prehabilitation on postoperative cognitive outcomes.

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“…One study included in our review included prehabilitation, yet data increasingly support a role for prehabilitation in the cancer setting, for example, presurgery 11 . A multiphase prehabilitation approach may be needed by many individuals with cancer to prepare for subsequent treatments such as chemotherapy, 11 and evidence in early‐stage breast cancer suggests that higher baseline (prechemotherapy) cardiovascular fitness and muscular strength may be associated with higher rates of chemotherapy completion 12 . This supports the potential utility of multiphase, multimodal prehabilitation in AML management, which should be considered for further research in AML.…”

Section: Author/year Study Design/sample Size Study Aim Intervention/...mentioning

confidence: 99%

Non‐pharmacological supportive‐care interventions in acute myeloid leukaemia: a review of randomised controlled trials

et al. 2021

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ADL, activity of daily living; AML, acute myeloid leukaemia; BFI, brief fatigue inventory; EORTC, European organisation for research and treatment of cancer; FACT-F, functional assessment of cancer therapy-fatigue; FVC, forced vital capacity; Gln, glutamine dipeptide; HADS, hospital anxiety and depression scale; H(S)CT, haematopoietic (stem) cell transplantation; HRmax, maximum heart rate; HRR, heart rate reserve; IC induction chemotherapy; IMT, inspiratory muscle training; IV, intravenous; IVC, inspiratory vital capacity; LASA, linear analogue self assessment; LOS, length of stay; MISWT, multistage incremental shuttle walk test; OS, overall survival; POMS, profile of mood states; PST, problem-solving training; QLQ-C30, quality of life questionnaire core 30-item; QoL, quality of life; RCT, randomised controlled trial; RPE, rating of perceived exertion; STS, sit-to-standing; TUG, timed up and go; VO 2 , oxygen uptake; 6MWT, 6-minute walk test.

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Multiphasic Prehabilitation Across the Cancer Continuum: A Narrative Review and Conceptual Framework

Cited by 60 publications

References 90 publications

Digital Support to Multimodal Community-Based Prehabilitation: Looking for Optimization of Health Value Generation

Digital Support to Multimodal Community-Based Prehabilitation: Looking for Optimization of Health Value Generation

Brain Prehabilitation for Oncologic Surgery

Non‐pharmacological supportive‐care interventions in acute myeloid leukaemia: a review of randomised controlled trials

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