The Impact of a Multimodal Sport Science-Based Prehabilitation Program on Clinical Outcomes in Abdominal Cancer Patients: A Cohort Study

Abstract

Background The potential for prehabilitation programs to impact clinical outcomes is uncertain in abdominal cancer patients due to the short window of time to intervene and the weakened state of the patients. To improve the effectiveness of prehabilitation intervention, a multimodal sports science approach was implemented. Methods Prior to cancer-related surgery, 21 patients participated in a 4-week exercise and nutrition prehabilitation program comprised of blood flow restriction exercise (BFR) and a sports nutrition supplement. Retrospective data of 71 abdominal cancer patients who underwent usual preoperative care was used as a comparator control group (CON). At 90 days post-surgery, clinical outcomes were quantified. Results Prehabilitation was associated with a shorter length of hospital stay ( P = .02) with 5.5 fewer days (4.7 ± 2.1 vs 10.2 ± 1.2 days in CON) and decreased incidence of any complications ( P = .03). Prehabilitation was not related to incidence of serious complications ( P = .17) or readmission rate ( P = .59). The prehabilitation group recorded 58% more steps on day 5 after surgery ( P = .043). Discussion A 4-week home-based prehabilitation program composed of BFR training and sports nutrition supplementation was effective in reducing postoperative complications and length of hospital stay in older patients with abdominal cancer. ClinicalTrials.gov Identifier: NCT04073381.

Beneath the cuff: Often overlooked and under-reported blood flow restriction device features and their potential impact on practice—A review of the current state of the research

“…The second study analyzed the benefits of a 4-week multi-modal prehabilitation program combining exercise with B-Strong™ bands and a sports nutrition supplement in 21 patients with abdominal cancer ( Wooten et al, 2022 ). While the results of the study indicated a beneficial effect on reducing complications ( p = 0.03) and length of hospital stay (∼5.5 fewer days, p = 0.02) as well as a 58% increase in step count 5-day post-op ( p = −.043), the comparison group was retrospectively analyzed (n = 71) and underwent usual standard of care without BFR or sports supplementation.…”

Surgical prehabilitation in older and frail individuals: a scoping review

“…47 However, prehabilitation was not related to the incidence of serious complications, readmission rate, changes in hand grip strength, fear of falling, the mental component of QoL, fasting serum concentrations of myostatin, follistatin, or growth hormone. 46,47…”

“…Furthermore, prehabilitation was associated with a shorter LOS ( P =0.02) with 5.5 fewer days (4.7±2.1 vs. 10.2±1.2 days) and decreased incidence of any complications ( P =0.03) compared with abdominal cancer patients who underwent usual preoperative care (n=71) 47. However, prehabilitation was not related to the incidence of serious complications, readmission rate, changes in hand grip strength, fear of falling, the mental component of QoL, fasting serum concentrations of myostatin, follistatin, or growth hormone 46,47…”

“…Among the trials included in this review, presurgical unimodal or multimodal interventions were examined in patients with (1) colorectal cancer (n = 10), 13,18,[21][22][23][24]30,33,40,41 pancreatic or hepatobiliary pancreatic cancer (n = 2), 16,38 gastric cancer (n = 2), 44,48 and esophageal cancer (n = 1) 27 undergoing a laparoscopic or open surgery, (2) knee osteoarthritis awaiting a total knee arthroplasty (TKA) (n = 5) 14,19.20,32,42 or hip osteoarthritis scheduled for total hip arthroplasty (THA) (n = 3), 19,28,29 (3) degenerative lumbar spine disorder (eg, disk herniation, spinal stenosis, and spondylolisthesis) scheduled for surgery (n = 1), 35 (4) coronary or valve heart disease (n = 2) 26,45 scheduled for coronary bypass graft surgery (CABG), valve replacement through sternotomy or transcatheter aortic valve replacement, (5) prostate cancer (n = 1) 15 undergoing Holmium laser enucleation or bladder cancer (n = 1) 31 undergoing cystectomy, (6) lung cancer (n = 3) 17,25,34 undergoing resection surgery, and ( 7) diverse mostly cancer-related major surgeries (eg, abdominal or intra-thoracic) (n = 6). 36,37,39,43,46,47 Details of included studies are presented in Table 1. Representative data from cited sources were used to generate a supporting figure for the review.…”

“…Thirteen intervention trials 16,18,21,22,24,25,27,30,33,36,41,44,[46][47][48] have examined the efficacy of multimodal prehabilitation in patients with colorectal cancer (n = 6), 18,21,22,30,33,41 gastric cancer (n = 2), 44,48 pancreatic cancer (n = 1), 16 lung cancer (n = 1), 25 esophageal cancer (n = 1) 27 before resection surgery, or in cancer or non-cancer patients undergoing major elective abdominal or thoracic surgeries (n = 2). 36,46,47…”