The purpose of the study is to evaluate the feasibility of recruitment procedure, intervention including compliance and the collaboration between in- and out patient clinics of preoperative home-based exercise in older people before colorectal surgery.
The feasibility study will be conducted in order to evaluate the study design of a future RCT. Feasibility data will eg. consist of study flow description, number of eligible participants, included participants, patients and instructors satisfaction with the intervention, training compliance, reasons for drop-outs, and adverse events. Patients waiting for colorectal surgery will be recruited and included after informed consent. Physical and respiratory function will be assessed at the hospital before the intervention, the day before surgery and the day before discharge. Data on postoperative complications, length of stay and mortality will be collected during the hospital stay. At baseline and six months after surgery, the participants will receive three questionnaires about level of independence in daily living, physical activity and health related quality of life. The intervention will be performed in the older person's home and consists of a combination of high-intensity respiratory training and individually adjusted functional exercise. Both groups will receive physical activity advice and malnutrition will be screened to optimize their nutritional status.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
23
The sessions will be led by a physiotherapist, in the older person's home. The sessions will consist of inspiratory muscle training with a resistance starting from 50% of their maximal capacity (30 breathes, 2 times/day). The training session will also consist of high-intensity individually adjusted functional strength and endurance training: chair-stand; stair climb/step up with weight belts, interval walking indoor and/or outdoor. This will be combined with functional task-exercises. The training will be conducted 2-3 times week, for at least two weeks or until they undergo surgery. During the remaining days, the participants will be instructed to follow the recommendation of 30 minutes of moderate physical activity per day, as well as to perform inspiratory muscle training.
Stockholm South General Hospital
Stockholm, Sweden
Recruitment Rate
The recruitment rate is calculated by the number of participants allocated to either the exercise group or control group from the total number of eligible participants (n=66).
Time frame: Baseline
Exercise Compliance
Compliance with the exercise intervention was defined as the number of sessions attended out of planned sessions and was registered in the exercise logs by the physiotherapists in primary care. Only participants randomized to the exercise group were evaluated for this assessment.
Time frame: At the end of the intervention, after 2-4 weeks
Acceptability
Patients and instructors satisfaction with the intervention measured with a survey. Instructors were not enrolled. Only participants randomized to the exercise group were evaluated for this assessment.
Time frame: At the end of the intervention, after 2-4 weeks
Adverse Events
Musculoskeletal-related events, cardiovascular episodes, falls and health care use that occurred during the exercise intervention before (pre)-surgery. Adverse events are only reported for the intervention group since the control group were a treatment as usual (TAU) group.
Time frame: During the intervention, after 1-4 weeks
Six-minute Walk
Meters completed, effort estimated
Time frame: Baseline, before surgery (after 2-4 weeks), before discharge app 4-10 days after surgery
Inspiratory Muscle Strength
Inspiratory muscle strength measured with MicroRPM.
Time frame: Baseline, before surgery (after 2-4 weeks), before discharge app 4-10 days after surgery
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Chair-stand 30-sec
Number of stands during 30 sec.
Time frame: Baseline, before surgery (after 2-4 weeks), before discharge app 4-10 days after surgery
Walking Speed
Normal walking speed was measured over 10 meters.
Time frame: Baseline, before surgery (after 2-4 weeks), before discharge app 4-10 days after surgery
Postoperative Complications
Clavien-Dindo, number of participants with at least one postoperative complication.
Time frame: Within the first 30 days of surgery
Length of Stay
Number of days admitted to the hospital
Time frame: At discharge, 2-4 weeks after baseline