BackgroundColorectal cancer (CRC) is the second most prevalent type of cancer in the world. Surgery is the only curative option. However, postoperative complications occur in up to 50% of patients and are associated with higher morbidity and mortality rates, lower health related quality of life (HRQoL) and increased expenditure in health care. The number and severity of complications are closely related to preoperative functional capacity, nutritional state, psychological state, and smoking behavior. Traditional approaches have targeted the postoperative period for rehabilitation and lifestyle changes. However, recent evidence shows that the preoperative period might be the optimal moment for intervention. This study will determine the impact of multimodal prehabilitation on patients’ functional capacity and postoperative complications.Methods/designThis international multicenter, prospective, randomized controlled trial will include 714 patients undergoing colorectal surgery for cancer. Patients will be allocated to the intervention group, which will receive 4 weeks of prehabilitation (group 1, prehab), or the control group, which will receive no prehabilitation (group 2, no prehab). Both groups will receive perioperative care in accordance with the enhanced recovery after surgery (ERAS) guidelines. The primary outcomes for measurement will be functional capacity (as assessed using the six-minute walk test (6MWT)) and postoperative status determined with the Comprehensive Complication Index (CCI). Secondary outcomes will include HRQoL, length of hospital stay (LOS) and a cost-effectiveness analysis.DiscussionMultimodal prehabilitation is expected to enhance patients’ functional capacity and to reduce postoperative complications. It may therefore result in increased survival and improved HRQoL. This is the first international multicenter study investigating multimodal prehabilitation for patients undergoing colorectal surgery for cancer.Trial registrationTrial Registry: NTR5947 – date of registration: 1 August 2016.

MA supplementation beneficially affected training-induced changes in lean body mass, muscle strength, and power, as well as hormonal responses and markers of muscle damage in response to 12 wk of resistance exercise training when compared with an isonitrogenous control.

The primary purpose of this investigation was to evaluate the influence of a whole body compression garment on recovery from a typical heavy resistance training workout in resistance-trained men and women. Eleven men (mean +/- SD: age, 23.0 +/- 2.9 years) and 9 women (mean +/- SD: age 23.1 +/- 2.2 years) who were highly resistance trained gave informed consent to participate in the study. A within-group (each subject acted as their own control), balanced, and randomized treatment design was used. Nutritional intakes, activity, and behavioral patterns (e.g., no pain medications, ice, or long showers over the 24 hours) were replicated 2 days before each test separated by 72 hours. An 8-exercise whole body heavy resistance exercise protocol using barbells (3 sets of 8-10 repetition maximum, 2.0- to 2.5-minute rest) was performed after which the subject showered and put on a specific whole body compression garment one designed for women and one for men (CG) or just wore his/her normal noncompression clothing (CON). Subjects were then tested after 24 hours. Dependent measures included sleep quality, vitality rating, resting fatigue rating, muscle soreness, muscle swelling via ultrasound, reaction movement times, bench throw power, countermovement vertical jump power, and serum concentrations of creatine kinase (CK) measured from a blood sample obtained via venipuncture of an arm vein. We observed significant (p < or = 0.05) differences between CG and CON conditions in both men and women for vitality (CG > CON), resting fatigue ratings (CG < CON), muscle soreness (CG < CON), ultrasound measure swelling (CG < CON), bench press throw (CG > CON), and CK (CG < CON). A whole body compression garment worn during the 24-hour recovery period after an intense heavy resistance training workout enhances various psychological, physiological, and a few performance markers of recovery compared with noncompressive control garment conditions. The use of compression appears to help in the recovery process after an intense heavy resistance training workout in men and women.

National Collegiate Athletic Association Division I athletes were tested to determine the load at which maximal mechanical output is achieved. Athletes performed power testing at 30, 40, 50, 60, and 70% of individual 1 repetition maximum (1RM) in the squat jump, bench press, and hang pull exercises. Additionally, hang pull power testing was performed using free-form (i.e., barbell) and fixed-form (i.e., Smith machine) techniques. There were differences between genders in optimal power output during the squat jump (30-40% of 1RM for men; 30-50% of 1RM for women) and bench throw (30% of 1RM for men; 30-50% of 1RM for women) exercises. There were no gender or form interactions during the hang pull exercise; maximal power output during the hang pull occurred at 30-60% of 1RM. In conclusion, these results indicate that (a) gender differences exist in the load at which maximal power output occurs during the squat jump and bench throw; and (b) although no gender or form interactions occurred during the hang pull exercise, greater power could be generated during fixed-form exercise. In general, 30% of 1RM will elicit peak power outputs for both genders and all exercises used in this study, allowing this standard percentage to be used as a starting point in order to train maximal mechanical power output capabilities in these lifts in strength trained athletes.

BACKGROUND Although prehabilitation programmes for patients undergoing major intra-abdominal cancer surgery have been shown to improve pre-operative physical fitness, the conclusions regarding any postoperative benefits are inconsistent. OBJECTIVES The aim of this study was to evaluate the content of and the outcome measures used in studies of prehabilitation programmes for these patients. It was hypothesised that the content of prehabilitation programmes is often therapeutically invalid, and that the postoperative outcomes assessed are inadequate to evaluate the impact of complications. DESIGN A systematic review of randomised controlled trials.

Physical activity is associated with improved breast cancer survival, but the underlying mechanisms, possibly including modification of the inflammatory state, are not well understood. We analyzed changes in interleukin (IL)-6, C-reactive protein (CRP), and TNF-α in a randomized controlled trial of exercise in postmenopausal breast cancer survivors. Seventy-five women, recruited through the Yale-New Haven Hospital Tumor Registry, were randomized to either a six-month aerobic exercise intervention or usual care. Correlations were calculated between baseline cytokines, adiposity, and physical activity measures. Generalized linear models were used to assess the effect of exercise on IL-6, CRP, and TNF-α. At baseline, IL-6 and CRP were positively correlated with body fat and body mass index (BMI) and were inversely correlated with daily pedometer steps (P < 0.001). We found no significant effect of exercise on changes in inflammatory marker concentrations between women randomized to exercise versus usual care, though secondary analyses revealed a significant reduction in IL-6 among exercisers who reached 80% of the intervention goal compared with those who did not. Future studies should examine the effect of different types and doses of exercise and weight loss on inflammatory markers in large-scale trials of women diagnosed with breast cancer.

Objective We examined the effect of 12 months aerobic and resistance exercise vs. usual care on changes in body composition in postmenopausal breast cancer survivors taking aromatase inhibitors (AIs). Methods 121 breast cancer survivors were enrolled in the Hormones and Physical Exercise (HOPE) study and randomized to either supervised twice-weekly resistance exercise training and 150 minutes per week of aerobic exercise (N=61) or a usual care (N=60) group. Dual energy X-ray absorptiometry (DXA) scans were conducted at baseline, 6-months, and 12-months to assess changes in body mass index (BMI), percent body fat (%FM), lean body mass (LBM) and bone mineral density (BMD). Results At 12-months, the exercise group relative to the usual care group had a significant increase in LBM (0.32 vs −0.88 kg, p=0.03), a decrease in %FM (−1.4 vs 0.48 %, p=0.03), and a decrease in BMI (−0.73 vs 0.17 kg/m2, p=0.03). Change in BMD was not significantly different between groups at 12 months (0.001 g/cm2 vs. −0.006 g/cm2, p=0.37). Conclusions A combined resistance and aerobic exercise intervention improved body composition in breast cancer survivors taking AIs. Exercise interventions may help to mitigate the negative side effects of AIs and improve health outcomes in breast cancer survivors.

The purpose of this investigation was to examine the influence of upper-body static stretching and dynamic stretching on upper-body muscular performance. Eleven healthy men, who were National Collegiate Athletic Association Division I track and field athletes (age, 19.6 +/- 1.7 years; body mass, 93.7 +/- 13.8 kg; height, 183.6 +/- 4.6 cm; bench press 1 repetition maximum [1RM], 106.2 +/- 23.0 kg), participated in this study. Over 4 sessions, subjects participated in 4 different stretching protocols (i.e., no stretching, static stretching, dynamic stretching, and combined static and dynamic stretching) in a balanced randomized order followed by 4 tests: 30% of 1 RM bench throw, isometric bench press, overhead medicine ball throw, and lateral medicine ball throw. Depending on the exercise, test peak power (Pmax), peak force (Fmax), peak acceleration (Amax), peak velocity (Vmax), and peak displacement (Dmax) were measured. There were no differences among stretch trials for Pmax, Fmax, Amax, Vmax, or Dmax for the bench throw or for Fmax for the isometric bench press. For the overhead medicine ball throw, there were no differences among stretch trials for Vmax or Dmax. For the lateral medicine ball throw, there was no difference in Vmax among stretch trials; however, Dmax was significantly larger (p