Patients with poor baseline walking capacity are most likely to improve their functional status with multimodal prehabilitation

Prehabilitation for adults diagnosed with cancer: A systematic review of long‐term physical function, nutrition and patient‐reported outcomes

“…Those participants with high levels of comorbidities and poor fitness were often not eligible to be included, which suggests those people most in need to improve physical function were less likely to receive prehabilitation. The multi‐modality approach of prehabilitation could optimise the management of cancer patients with low baseline scores and who have been shown to gain greater benefits (Minnella et al, ). Rather than trying to demonstrate the efficacy of multi‐modality prehabilitation on the fittest patients, we should consider using the approach to optimise the management of the more complex and least fit cancer patients who have most to gain.…”

“…Those participants with high levels of comorbidities and poor fitness were often not eligible to be included, which suggests those people most in need to improve physical function were less likely to receive prehabilitation. The multi-modality approach of prehabilitation could optimise the management of cancer patients with low baseline scores and who have been shown to gain greater benefits (Minnella et al, 2016).…”

The role of Perioperative Surgical Home on health and longevity in society: importance of the surgical prehabilitation program

“…The American Cancer Society has published a broad exercise guideline that recommends at least 150 min of moderate or 75 min of vigorous intensity (or combination of) exercise per week and includes 2−3 sessions of resistance training, involving major muscle groups [21]. For example, a certified kinesiologist assessed and trained each participant to perform home-based training, consisting of aerobic, resistance and flexibility exercise up to 50 min three times per week [22,23]. For aerobic exercise, cycling, walking, or swimming is used based on the physical capacity of each patient, assessed using the 6-min walking test distance.…”

“…For example, a registered dietician estimates macronutrient and energy intake from each patient's food record, and discusses dietary goals with each patient. Patients can be provided protein supplementation to reach a daily intake of up to 1.2 g of protein/kg of body weight, as per the European Society of Parenteral and Enteral Nutrition guidelines for surgical patients [22][23][24]. Protein supplement is recommended to be ingested within 1 h post exercise (anabolic window).…”

“…In particular, psychological factors can be modifiable by intervention, although the type and the degree of psychological factors are variable. For example, a trained psychologist can instruct each patient on relaxation techniques and breathing exercises to reduce anxiety [23,24]. Patients practice with the psychologist during the initial visit and then an instructional CD is provided for performing the exercises at home until the operation.…”