Feasibility and preliminary effectiveness of preoperative therapeutic exercise in patients with cancer: A pragmatic study

Timmerman, Hans; Groot, Janke F. de; Hulzebos, H.J.; Knikker, R de; Kerkkamp, H. E. M.; Meeteren, N.L.U. van

doi:10.3109/09593981003761509

Cited by 55 publications

(31 citation statements)

References 30 publications

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“…However, of the patients eligible for the exercise program based on the available time until surgery, 68% participated in the exercise program. A participation rate of 68% is reasonable, since other preoperative training studies report lower participation rates [19,37]. Having to travel to the outpatient hospital clinic twice a week was the most frequently reported reason for non-participation, which is in line with an earlier reported pilot study [19].…”

Section: Discussionsupporting

confidence: 81%

“…Research on prehabilitation programs aimed at improving the overall exercise capacity and muscle strength before surgery is less common. Only a few pilot studies have investigated the effect of an exercise program before oncological surgery [9,19]. For this reason, a preoperative exercise program was designed to improve the physical status of patients scheduled for gastrointestinal oncological surgery.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of Exercise Training in Cancer Patients Scheduled for Elective Gastrointestinal Surgery

Valkenet¹,

Trappenburg²,

Schippers

et al. 2016

Dig Surg

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Background/Aims: This study examines the feasibility of a preoperative exercise program to improve the physical fitness of a patient before gastrointestinal surgery. Methods: An outpatient exercise program was developed to increase preoperative aerobic capacity, peripheral muscle endurance and respiratory muscle function in patients with pancreatic, liver, intestinal, gastric or esophageal cancer. During a consult at the outpatient clinic, patients were invited to participate in the exercise program when their surgery was not scheduled within 2 weeks. Results: The 115 participants followed on average 5.7 (3.5) training sessions. Adherence to the exercise program was high: 82% of the planned training sessions were attended, and no adverse events occurred. Mixed model analyses showed a significant increase of maximal inspiratory muscle strength (84.1-104.7 cm H₂O; p = 0.00) and inspiratory muscle endurance (35.0-39.5 cm H₂O; p = 0.00). No significant changes were found in aerobic capacity and peripheral muscle strength. Conclusion: This exercise program in patients awaiting oncological surgery is feasible in terms of participation and adherence. Inspiratory muscle function improved significantly as a result of inspiratory muscle training. The exercise program however failed to result in improved aerobic capacity and peripheral muscle strength, probably due to the limited number of training sessions as a result of the restricted time interval between screening and surgery.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Feasibility of Exercise Training in Cancer Patients Scheduled for Elective Gastrointestinal Surgery

Valkenet¹,

Trappenburg²,

Schippers

et al. 2016

Dig Surg

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“…Nine studies were identified and underwent full text review [14][15][16][17][18][19][20][21][22] (Figure 1). One hundred and twenty two studies were identified from the initial literature search and twenty-one from handsearching the study references and through other sources.…”

Section: Description Of Included and Excluded Studiesmentioning

confidence: 99%

“…Nine studies underwent full text review and one of these studies was excluded as it included non-colorectal cancer patients [14]. Therefore, eight studies were included in the qualitative synthesis.…”

Section: Description Of Included and Excluded Studiesmentioning

confidence: 99%

Systematic review of pre-operative exercise in colorectal cancer patients

et al. 2015

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A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription. AcknowledgementsThe authors declare that they have no conflicts of interest. We would like to acknowledge the help of Suzanne Toft, the clinical librarian who conducted the electronic search strategy.2 Abstract PurposeThe aim of this systematic review was to evaluate the evidence for exercise interventions prior to surgery for colorectal cancer resection. The evidence for use of exercise to improve physical fitness and surgical outcomes is as yet unknown. MethodA systematic search was performed of MEDLINE, EMBASE, CINAHL, AMED and BNI databases for studies involving pre-operative exercise in colorectal cancer patients. ResultsEight studies were included in the review. There is evidence that pre-operative exercise improves functional fitness, and to a lesser extent objectively measurable cardio-respiratory fitness prior to colorectal cancer resection. There is no clear evidence at present that this improvement in fitness translates into reduced peri-operative risk or improved post-operative outcomes. Current studies are limited by risk of bias. ConclusionsThis review highlights the common difficulty in transferring promising results in a research setting, into significant improvements in the clinical arena. Future research should focus on which type of exercise is most likely to maximise patient adherence and improvements in cardio-respiratory fitness.Ultimately, adequately powered, randomised controlled trials are needed to investigate if pre-operative exercise improves post-operative morbidity and mortality.

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“…There is however a dearth of evidence in this area. One pilot study by Timmerman et al (5), examined the impact of a pre-operative exercise programme only in 39 cancer patients scheduled for elective surgery, included five oesophageal cancer patients, and found significant improvements in exercise capacity could be achieved pre-operatively. Considerable work is required to identify suitable exercise modalities for this purpose.…”

mentioning

confidence: 99%