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

Abstract

Background: Sedentary behavior is emerging as an important field of scientific enquiry for cancer survivorship. The posttreatment period is associated with prolonged recovery, deterioration in quality of life, disability, poor mental health, and reduced productivity. Exercise in cancer survivors has been linked with reduced fatigue, improved functional outcomes, and improved survival. Purpose: To evaluate the effect of a surgical cancer prehabilitation program on the long-term physical and psychological health in a cohort of patients undergoing surgery for esophagogastric cancer. Methods: The PREPARE program is a multimodal cancer prehabilitation program. All patients who underwent curative esophagogastric cancer surgery and completed the PREPARE program were included in the study. Weekly activity scores, self-efficacy, exercise testing, and hand grip strength were assessed. Results: A total of 39 patients met the eligibility criteria. At baseline, 31% of patients were active, 13% were moderately active, and 56% were insufficiently active. At follow-up, 44% of patients were active, 13% were moderately active, and 44% were insufficiently active. There was a significant increase in leisure score index (P = .048, z = −1.981), JOURNAL/reonc/04.03/01893697-202007000-00004/4FSM1/v/2023-08-24T151015Z/r/image-gif o 2max, mL.kg−1.min−1 (P ≤ .01), and hand grip strength (P ≤ .01) from baseline to follow-up. There was no change in self-efficacy through baseline to follow-up. Limitations: Improvements in the postoperative period could be expected as part of recovery. The absence of a control group makes this difficult to establish. Conclusion: Starting prehabilitation at the time of diagnosis leads to sustained confidence and improved activity and exercise levels in the posttreatment period.

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

“…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 ).…”

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

“…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.…”

“…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.…”

“…The nine NRSs 65,67,71,73,80,89,98,99,112 included only adult participants. However, Macchi et al 98 included only adults aged ≥ 65 years.…”

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

“…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.…”