Is preoperative physical activity related to post-surgery recovery?—a cohort study of colorectal cancer patients

Onerup, Aron; Bock, David; Börjesson, Mats; Olsén, Monika Fagevik; Gellerstedt, Martin; Haglind, Eva; Nilsson, Hanna; Angenete, Eva

doi:10.1007/s00384-016-2551-4

Cited by 30 publications

(35 citation statements)

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“…Several other studies have examined the effect of pre-surgery activity on recovery of physical functioning among CRC patients. In contrast to our result, one study concluded that a higher pre-operative physical activity level was associated with a faster self-reported recovery after surgery [35]. However, that study measured recovery at 3 and 6 weeks after surgery and only used the single question “to what extent do you feel physically recovered?” to measure recovery among 115 CRC patients.…”

Section: Discussioncontrasting

confidence: 91%

An increase in physical activity after colorectal cancer surgery is associated with improved recovery of physical functioning: a prospective cohort study

et al. 2017

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BackgroundThe influence of physical activity on patient-reported recovery of physical functioning after colorectal cancer (CRC) surgery is unknown. Therefore, we studied recovery of physical functioning after hospital discharge by (a) a relative increase in physical activity level and (b) absolute activity levels before and after surgery.MethodsWe included 327 incident CRC patients (stages I–III) from a prospective observational study. Patients completed questionnaires that assessed physical functioning and moderate-to-vigorous physical activity shortly after diagnosis and 6 months later. Cox regression models were used to calculate prevalence ratios (PRs) of no recovery of physical functioning. All PRs were adjusted for age, sex, physical functioning before surgery, stage of disease, ostomy and body mass index.ResultsAt 6 months post-diagnosis 54% of CRC patients had not recovered to pre-operative physical functioning. Patients who increased their activity by at least 60 min/week were 43% more likely to recover physical function (adjusted PR 0.57 95%CI 0.39–0.82), compared with those with stable activity levels. Higher post-surgery levels of physical activity were also positively associated with recovery (P for trend = 0.01). In contrast, activity level before surgery was not associated with recovery (P for trend = 0.24).ConclusionsAt 6 month post-diagnosis, about half of CRC patients had not recovered to preoperative functioning. An increase in moderate-to-vigorous physical activity after CRC surgery was associated with enhanced recovery of physical functioning. This benefit was seen regardless of physical activity level before surgery. These associations provide evidence to further explore connections between physical activity and recovery from CRC surgery after discharge from the hospital.

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Section: Discussioncontrasting

confidence: 91%

An increase in physical activity after colorectal cancer surgery is associated with improved recovery of physical functioning: a prospective cohort study

et al. 2017

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“…In two observational studies, one on breast and the other on colorectal cancer, a higher preoperative level of physical activity was associated with faster physical recovery as reported by the patients 3 weeks after surgery [8,9]. In a previously published study of patients in the LAPPRO trial, it was found that a high level of physical activity preoperatively was associated with reduced need for sick leave after radical prostatectomy compared to men with lower physical activity [10].…”

Section: Introductionmentioning

confidence: 94%

Habits and self-assessed quality of life, negative intrusive thoughts and depressed mood in patients with prostate cancer: a longitudinal study

Bock

Angenete

Bjartell

et al. 2017

Scandinavian Journal of Urology

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“…Answering categories are 0%, 25%, 50%, 75% and 100%. This question has been validated face-to-face and has previously been used in several cohort studies [28–30]. …”

Section: Methodsmentioning

confidence: 99%

“…Patient-reported experienced mental recovery 4 weeks and 12 months post-operatively, used in previous observational cohort studies [28–30]…”

Section: Methodsmentioning

confidence: 99%

The effect of pre- and post-operative physical activity on recovery after colorectal cancer surgery (PHYSSURG-C): study protocol for a randomised controlled trial

Onerup

Angenete

Bock

et al. 2017

Trials

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BackgroundSurgery for colorectal cancer is associated with a high risk of post-operative adverse events, re-operations and a prolonged post-operative recovery. Previously, the effect of prehabilitation (pre-operative physical activity) has been studied for different types of surgery, including colorectal surgery. However, the trials on colorectal surgery have been of limited methodological quality and size. The aim of this trial is to compare the effect of a combined pre- and post-operative intervention of moderate aerobic physical activity and inspiratory muscle training (IMT) with standard care on post-operative recovery after surgery for colorectal cancer.Methods/designWe are conducting a randomised, controlled, parallel-group, open-label, multi-centre trial with physical recovery within 4 weeks after cancer surgery as the primary endpoint. Some 640 patients planned for surgery for colorectal cancer will be enrolled. The intervention consists of pre- and post-operative physical activity with increased daily aerobic activity of moderate intensity as well as IMT. In the control group, patients will be advised to continue their normal daily exercise routine. The primary outcome is patient-reported physical recovery 4 weeks post-operatively. Secondary outcomes are length of sick leave, complication rate and severity, length of hospital stay, re-admittances, re-operations, post-operative mental recovery, quality of life and mortality, as well as changes in insulin-like growth factor 1 and insulin-like growth factor-binding protein 3, perception of pain and a health economic analysis.DiscussionAn increase in moderate-intensity aerobic physical activity is a safe, cheap and feasible intervention that would be possible to implement in standard care for patients with colorectal cancer. If shown to be effective, this lifestyle intervention could be a clinical parallel to pre-operative smoke cessation that has already been implemented with good clinical results.Trial registrationClinicalTrials.gov identifier: NCT02299596. Registered on 17 November 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-1949-9) contains supplementary material, which is available to authorized users.

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Is preoperative physical activity related to post-surgery recovery?—a cohort study of colorectal cancer patients

Abstract: We examined preoperative physical activity and the recovery after colorectal cancer surgery. Physically active individuals had faster self-assessed physical recovery. Assessment of preoperative physical activity may provide prognostic clinical information.

Cited by 30 publications

References 35 publications

An increase in physical activity after colorectal cancer surgery is associated with improved recovery of physical functioning: a prospective cohort study

An increase in physical activity after colorectal cancer surgery is associated with improved recovery of physical functioning: a prospective cohort study

Habits and self-assessed quality of life, negative intrusive thoughts and depressed mood in patients with prostate cancer: a longitudinal study

The effect of pre- and post-operative physical activity on recovery after colorectal cancer surgery (PHYSSURG-C): study protocol for a randomised controlled trial

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