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

Abstract

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.

The pre- and postoperative course of functional status in patients undergoing esophageal cancer surgery

“…Moreover, there seems to be no relationship between preoperative functional status and postoperative recovery in our study cohort. This is in line with a study by Valkenet et al (2016) [35] who did not find any significant improvements in aerobic capacity, HGS, knee extension strength and elbow flexion strength after a preoperative exercise program in a comparable group of cancer patients scheduled for elective gastrointestinal surgery. The authors suggested that the results could be due to the relatively short training period, but the high fitness levels of these patients could also be an explanation for the lack of effectiveness.…”

The effect of a pre- and post-operative exercise programme versus standard care on physical fitness of patients with oesophageal and gastric cancer undergoing neoadjuvant treatment prior to surgery (The PERIOP-OG Trial): Study protocol for a randomised controlled trial

“…They appear to improve patient functional status, HRQoL and, possibly, peri-operative morbidity [20]. Functional capacity may significantly improve during NCT when a prehabilitation programme is instituted [46,[48][49][50][51][52][53][54]. The use of exercise interventions and their timelines are inconsistently reported in the published literature as are the associated outcome measures that have included maximal inspiratory pressure [48][49][50], 6MWT [46,52], gait speed [53], FEV1/FVC [51], VO2max and hand grip strength [49,50].…”

Human Movement Monitoring and Analysis for Prehabilitation Process Management

“…For example, light intensity cycling produces a common frequency of 0.75 Hz, with an amplitude of 20-30 m/s 2 , moderate cycling corresponds to 1 Hz at 40-55 m/s 2 , and vigorous to 1.25 Hz and 55-90 m/s 2 . However, several prehabilitation exercises for cancer patients (e.g., rowing, step up machine, cross-trainer machine, leg press, and interval training) have received less attention [12]. Whether findings from healthy young populations can be transferred to patients with abdominal cancer is questionable.…”