Study of Long-Term Follow-up of Exercise Levels Following Participation in a Prehabilitation Program in Esophagogastric Cancer

Doganay, Emre; Wynter-Blyth, Venetia; Halliday, Laura J.; MacKinnon, Tom; Osborn, Hayley; Moorthy, Krishna

doi:10.1097/01.reo.0000000000000205

Cited by 3 publications

(30 citation statements)

References 36 publications

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“…Figure 1 shows the PRISMA diagram with exclusion reasons. In total these 36 manuscripts described 33 unique programs; three programs were described in 2–3 different manuscripts ( 26 , 27 , 32 , 33 , 38 , 39 , 47 , 52 ), two manuscripts described 2 or 3 unique programs ( 22 , 31 ).…”

Section: Resultsmentioning

confidence: 99%

Evaluation of the Structure and Health Impacts of Exercise-Based Cardiac and Pulmonary Rehabilitation and Prehabilitation for Individuals With Cancer: A Systematic Review and Meta-Analysis

Rickard

Eswaran

Small

et al. 2021

Front. Cardiovasc. Med.

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Exercise-based, multimodal rehabilitation programming similar to that used in the existing models of cardiac or pulmonary rehabilitation or prehabilitation is a holistic potential solution to address the range of physical, psychological, and existential (e.g., as their diagnosis relates to potential death) stressors associated with a cancer diagnosis and subsequent treatment. The purpose of this study was to systematically evaluate the structure and format of any type of exercise-based, multimodal rehabilitation programs used in individuals with cancer and the evidence base for their real-world effectiveness on metrics of physical (e.g., cardiorespiratory fitness, blood pressure) and psychological (e.g., health-related quality of life) health. Very few of the 33 included exercise-based, multimodal rehabilitation programs employed intervention components, education topics, and program support staff that were multi-disciplinary or cancer-specific. In particular, a greater emphasis on nutrition care, and the evaluation and management of psychosocial distress and CVD risk factors, with cancer-specific adaptations, would broaden and maximize the holistic health benefits of exercise-based rehabilitation. Despite these opportunities for improvement, exercise-based, multimodal rehabilitation programs utilized under real-world settings in individuals with cancer produced clinically meaningful and large effect sizes for cardiorespiratory fitness (VO2peak, ±2.9 mL/kg/min, 95% CI = 2.6 to 3.3) and 6-minute walk distance (+47 meters, 95% CI = 23 to 71), and medium effect sizes for various measures of cancer-specific, health-related quality of life. However, there were no changes to blood pressure, body mass index, or lung function. Overall, these findings suggest that exercise-based, multimodal rehabilitation is a real-world therapy that improves physical and psychological health among individuals with cancer, but the holistic health benefits of this intervention would likely be enhanced by addressing nutrition, psychosocial concerns, and risk factor management through education and counselling with consideration of the needs of an individual with cancer.

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Section: Resultsmentioning

confidence: 99%

Evaluation of the Structure and Health Impacts of Exercise-Based Cardiac and Pulmonary Rehabilitation and Prehabilitation for Individuals With Cancer: A Systematic Review and Meta-Analysis

Rickard

Eswaran

Small

et al. 2021

Front. Cardiovasc. Med.

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“…Of the remaining nine studies, five were single-group, single-centre, before-and-after comparisons; 65,67,71,89,98 two were single-group, multicentre, before-and-after comparisons; 80,99 one was a parallel-design, multicentre before-and-after comparison; 112 and one was a parallel-design, single-centre controlled before-and-after study. 73 In the RCTs and Q-RCTs, a total of 7939 participants were randomised.…”

Section: Included Studiesmentioning

confidence: 99%

“…The nine NRSs 65,67,71,73,80,89,98,99,112 reported no non-surgical participants, or we judged them as being likely to include no, or an insignificant number of, non-surgical participants.…”

Section: Surgical/non-surgical Participantsmentioning

confidence: 99%

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Perioperative exercise programmes to promote physical activity in the medium to long term: systematic review and qualitative research

Pritchard

Robinson

Lewis

et al. 2022

Health Soc Care Deliv Res

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Background In England, more than 4 million hospital admissions lead to surgery each year. The perioperative encounter (from initial presentation in primary care to postoperative return to function) offers potential for substantial health gains in the wider sense and over the longer term. Objectives The aim was to identify, examine and set in context a range of interventions applied perioperatively to facilitate physical activity in the medium to long term. Data sources The following databases were searched – Cochrane Central Register of Controlled Trials, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, EMBASE, PsycINFO and SPORTDiscus in October 2020. Clinical trials databases were also searched, and backward and forward citation searches were conducted. Review methods We undertook a systematic review; ran database searches in October 2020; extracted data; conducted risk-of-bias assessments of studies; and used Grading of Recommendations Assessment, Development and Evaluation assessments. We conducted focus groups and interviews with people running services designed to promote physical activity, to understand the practical and contextual factors that make such interventions ‘work’. Although the two streams of work were conducted independently, we considered overlapping themes from their findings. Results In the review, we found 51 randomised controlled trials and two quasi-randomised trials; nine non-randomised studies formed a supplementary data set. Studies included 8604 adults who had undergone (or were undergoing) surgery, and compared 67 interventions facilitating physical activity. Most interventions were started postoperatively and included multiple components, grouped as follows: education and advice, behavioural mechanisms and physical activity instruction. Outcomes were often measured using different tools; pooling of data was not always feasible. Compared with usual care, interventions may have slightly increased the amount of physical activity, engagement in physical activity and health-related quality of life at the study’s end (moderate-certainty evidence). We found low-certainty evidence of an increase in physical fitness and a reduction in pain, although effects generally favoured interventions. Few studies reported adherence and adverse events; certainty of these findings was very low. Although infrequently reported, participants generally provided positive feedback. For the case studies, we conducted two online focus groups and two individual interviews between November 2020 and January 2021, with nine participants from eight services of physical activity programmes. Conceptual and practical aspects included how the promotion of physical activity can be framed around the individual to recruit and retain patients; how services benefit from committed and compassionate staff; how enthusiasts, data collection and evidence play key roles; and how digital delivery could work as part of a blended approach, but inequalities in access must be considered. Limitations Outcome measures in the review varied and, despite a large data set, not all studies could be pooled. This also limited the exploration of differences between interventions; components of interventions often overlapped between studies, and we could not always determine what ‘usual care’ involved. The case study exploration was limited by COVID-19 restrictions; we were unable to visit sites and observe practice, and the range of services in the focus groups was also limited. Conclusions Evidence from the review indicates that interventions delivered in the perioperative setting, aimed at enhancing physical activity in the longer term, may have overall benefit. The qualitative analysis complemented these findings and indicated that interventions should be focused around the individual, delivered locally and compassionately, and promoted by a patient’s full clinical team. There is a need to develop a core outcome set for similar studies to allow quantitative synthesis. Future work should also investigate the experiences of patients in different contexts, such as different communities, and with different surgical indications. Study registration This study is registered as PROSPERO CRD42019139008. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 10, No. 21. See the NIHR Journals Library website for further project information.

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“…Research has shown that PA helps alleviate the symptoms of cancer-related fatigue by increasing VO 2 max results (improving aerobic performance) [ 30 ] and increasing flexibility, thus reducing physical pain [ 31 ]. Van Vulpen et al [ 32 ] conducted a meta-analysis which found that supervised PA sessions elicited significantly more improvements in fatigue reduction compared to unsupervised sessions, highlighting the importance of controlled rehabilitation programmes.…”

Section: Introductionmentioning

confidence: 99%

The Role of Physical Activity in Cancer Recovery: An Exercise Practitioner’s Perspective

Roscoe

Pringle

Chandler

et al. 2022

IJERPH

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Less than 20% of cancer patients meet the recommended physical activity (PA) guidelines, partially due to poor knowledge and enforcement/encouragement amongst health-care professionals (HCPs). The primary aim of this study was to explore the perceptions of exercise practitioners on the role of PA and the physiological and psychological benefits to recovering cancer patients; the secondary aim was to understand the barriers and facilitators of promoting PA to cancer survivors. The third aim was to, seek the perspectives on the effectiveness of referral systems between the hospitals and PA structures. A purposive sample of five exercise practitioners’ (four male and one female) with experience with cancer patients participated in a semi-structured interview (45–60 min). Interviews addressed five key topics: intervention procedures, patient well-being, patient education on PA, effectiveness of referrals from hospitals, and post-intervention PA. Interviews were transcribed verbatim and analysed via thematic analysis. The participants believed that recovering cancer patients possess a knowledge of the physiological benefits of PA, yet psychological understanding remains unknown. Social environments are key to participation in PA and most HCPs lacked knowledge/awareness of the benefits of engaging in PA. There is a need to improve HCPs knowledge of the benefits of PA, whilst providing standardised training on how PA can improve cancer patients’ outcomes.

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Study of Long-Term Follow-up of Exercise Levels Following Participation in a Prehabilitation Program in Esophagogastric Cancer

Cited by 3 publications

References 36 publications

Evaluation of the Structure and Health Impacts of Exercise-Based Cardiac and Pulmonary Rehabilitation and Prehabilitation for Individuals With Cancer: A Systematic Review and Meta-Analysis

Evaluation of the Structure and Health Impacts of Exercise-Based Cardiac and Pulmonary Rehabilitation and Prehabilitation for Individuals With Cancer: A Systematic Review and Meta-Analysis

Perioperative exercise programmes to promote physical activity in the medium to long term: systematic review and qualitative research

The Role of Physical Activity in Cancer Recovery: An Exercise Practitioner’s Perspective

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