This study examines whether a home-based telephone-guided preoperative exercise programme is feasible and effective in improving cardiorespiratory fitness in patients with colorectal cancer who are high risk due to their existing co-morbidity.
Preoperative exercise, also know as prehabilitation, has been shown to improve physical fitness and potentially reduce postoperative complications in patients undergoing surgery. Patients are often labelled high risk for surgery due to their existing ill-health e.g. heart and lung disease. High risk patients comprise approximately 12% of all elective cancer cases, but account for 80% of all post-operative mortality. Complications significantly affect the quality of life of each CRC patient, both in the short and long-term, and can also impact on survival. It is critical that patients who are deemed at high risk of complications are optimised in the preoperative period. Exercise in the period before surgery is therefore one potential method of improving high risk patients' physical fitness levels while potentially reducing their risk of postoperative complications and subsequent mortality.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
72
Graduated walking programme, strengthening exercises and respiratory muscle training.
Hairmyres Hospital
East Kilbride, United Kingdom
Queen Elizabeth University Hospital
Glasgow, United Kingdom
University Hospital Crosshouse
Kilmarnock, United Kingdom
Royal Alexandra Hospital
Paisley, United Kingdom
Change in cardiorespiratory fitness
Anaerobic threshold as measured by CPET
Time frame: Preoperative period: 4 weeks
Length of stay in high dependency and intensive care
Critical Care bed days
Time frame: Postoperative period: up to 8 weeks
Readmission to critical care
Critical Care bed days
Time frame: Postoperative period: up to 8 weeks (within index admission)
Time to medical discharge
Medically fit for discharge
Time frame: Postoperative period: up to 8 weeks.
Hospital length of stay
Days
Time frame: Postoperative period: within 30 days.
Readmission rate
Time frame: Within 30 days of discharge.
Post-operative morbidity
Clavien-Dindo Scale
Time frame: Post-operative period: at 30 days post-surgery (week 8).
Health-related quality of life
SF-36
Time frame: Baseline (week 0), post-intervention (week 4), at 30 days postoperatively (week 8).
Health-related quality of life
EORTC QLQ-C30
Time frame: Baseline (week 0), post-intervention (week 4), at 30 days postoperatively (week 8).
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Psychological health
Hospital Anxiety and Depression Score (HADS)
Time frame: Baseline (week 0), post-intervention (week 4), at 30 days postoperatively (week 8).
Frailty
Clinical Frailty Score (CSHA)
Time frame: Baseline (week 0) and repeat testing (week 4).
Redox blood samples
Redox status in pre- and post-exercise blood samples
Time frame: Baseline (week 0) and repeat CPET (week 4).
Survival
Overall and cancer-specific
Time frame: 3 years post-operatively.