Older frail prehabilitated patients who cannot attain a 400 m 6-min walking distance before colorectal surgery suffer more postoperative complications

Association between self-assessed preoperative level of physical activity and postoperative complications – An observational cohort analysis within a randomized controlled trial (PHYSSURG-C)

“…However, the method of performing observational studies on associations between physical activity or functional capacity and postoperative outcomes within an RCT has been done before. Gillis et al performed an observational analysis of frail participants with colorectal cancer who had low functional capacity within a RCT of preoperative exercise before colorectal cancer surgery [23]. They reported that participants with low functional capacity at the time of surgery were more likely to suffer postoperative complications.…”

Preoperative physical performance as predictor of postoperative outcomes in patients aged 65 and older scheduled for major abdominal cancer surgery: A systematic review

“…A recent RCT in patients with poor cardiopulmonary fitness based on low anaerobic threshold (<11 ml/kg/ min) undergoing colorectal cancer surgery showed that patients who received a moderate-to-high intensity exercise intervention experienced significant preoperative improvements in CPET parameters and had less complications than the control group [49]. Another recent RCT showed that frail older patients with colorectal cancer who had received moderate intensity exercise prehabilitation but were afterwards unable to attain 400 m on the 6MWT suffered more postoperative complications, implying that 400 m could be set as the minimum threshold to indicate successful prehabilitation [50]. It may also be possible to mitigate low muscle mass and strength through exercise and nutritional interventions, although data on the effectiveness of interventions to combat sarcopenia in older patients undergoing cancer surgery are still scarce [51].…”

Preoperative physical activity and frailty in older patients undergoing cancer surgery – PREsurgery study

“…It would be interesting to use accelerometry to explore whether there is a threshold for harmful sedentary behavior with regard to adverse outcomes and whether decreasing overall sedentary time would be enough to prevent negative outcomes. Results of a recent study suggest that older frail patients should reach 400 m on the 6-min walking test to lower the risk for postoperative complications [9]. It should be determined if a specific training program is necessary or if increasing normal daily activity is enough to reach this goal.…”