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Del Bianco N, Borsati A, Toniolo L, Ciurnielli C, Belluomini L, Insolda J, Sposito M, Milella M, Schena F, Pilotto S, Avancini A. What is the role of physical exercise in the era of cancer prehabilitation? A systematic review. Crit Rev Oncol Hematol 2024; 198:104350. [PMID: 38642726 DOI: 10.1016/j.critrevonc.2024.104350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 03/18/2024] [Accepted: 04/10/2024] [Indexed: 04/22/2024] Open
Abstract
PURPOSE Exercise before surgery, as part of prehabilitation, aiming to enhance patients' functional and physiological capacity, has become widespread, necessitating an in-depth understanding. METHODS A systematic search was conducted on Pubmed, Cochrane, and Scopus to examine the effect of exercise as prehabilitation, alone or in combination with other interventions, in patients with cancer. Interventional studies applying a single-arm, randomized controlled, or nonrandomized design were included. RESULTS A total of 96 studies were included, and categorized according to cancer types, i.e., gynecological, breast, urological, gastrointestinal and lung cancer. For each cancer site, the effect of exercise, on physical fitness parameters and postoperative outcomes, including length of hospital stay and postoperative complications, was reported. CONCLUSION Exercise as prehabilitation may have an important role in improving physical fitness, postoperative outcomes, and accelerating recovery, especially in certain types of malignancies.
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Affiliation(s)
- Nicole Del Bianco
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Anita Borsati
- Department of Medicine, Verona University Hospital Trust, Verona, Italy
| | - Linda Toniolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Christian Ciurnielli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Lorenzo Belluomini
- Section of Oncology, Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - Jessica Insolda
- Section of Oncology, Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - Marco Sposito
- Section of Oncology, Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - Michele Milella
- Section of Oncology, Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - Federico Schena
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sara Pilotto
- Section of Oncology, Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy.
| | - Alice Avancini
- Section of Oncology, Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
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Yang L, Alice A, Friedenreich CM. Physical activity for cancer prehabilitation: A scoping review. Crit Rev Oncol Hematol 2024; 196:104319. [PMID: 38460927 DOI: 10.1016/j.critrevonc.2024.104319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/11/2024] Open
Abstract
This scoping review aims to synthesize the current landscape of physical activity in cancer prehabilitation and identify knowledge gaps. We searched MEDLINE, EMBASE, SCOPUS and WEB OF SCIENCE for exercise interventions and observational studies that measured exercise or physical activity before cancer treatment from inception to January 20, 2023. Fifty-one articles from 44 unique studies were reviewed, including 32 intervention and 12 observational studies. Surgery is the only treatment modality that has been investigated. Included studies used heterogeneous exercise interventions and measures for physical activity. Colorectal and other gastrointestinal, lung, and urologic cancers are the most studied cancer types. Exercise intervention in cancer prehabilitation is highly feasible. The evidence for improved fitness, functional, psychosocial, and clinical outcomes is promising yet limited. Although research has increased recently, prehabilitation exercise remains a relatively under-investigated area in oncology. We have provided research directions towards an ideal cancer prehabilitation design in the real-world setting.
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Affiliation(s)
- Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Canada; Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Canada.
| | - Azam Alice
- Adapted Physical Activity and Health, University Rennes 2, Rennes, France
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Canada; Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Canada
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3
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Perlmutter BC, Ali J, Cengiz TB, Said SAD, Tang A, Augustin T, Joyce D, Simon R, Walsh RM. Correlation between physical status measures and frailty score in patients undergoing pancreatic resection. Surgery 2021; 171:711-717. [PMID: 34848074 DOI: 10.1016/j.surg.2021.10.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/04/2021] [Accepted: 10/08/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND This study aimed to assess the correlation between validated measures of physical status in a prehabilitation regimen with an established frailty score and analyze changes in these measures after completion of a directed prehabilitation program among patients undergoing elective pancreatic resection. METHODS Adult patients undergoing pancreatic resection from 2019-2021 were enrolled in a pilot prehabilitation program. Three validated measures of physical status were used: the 6-minute walk test, grip strength, and chair-stand test. The prehabilitation program comprised 7,500 steps, 30 grip strength exercises, and 100 chair-stand exercises daily. Patients' frailty score was calculated using the Modified Johns Hopkins Frailty score. Changes in physical status measures after prehabilitation and postoperative outcomes were compared. RESULTS Thirty-two patients with a median age of 69.0 years (interquartile range = 59.5-76.3 years) were included. Patients' median duration of participation was 21.5 days (interquartile range = 16-29 days). There was a negative correlation between increasing frailty score and baseline the 6-minute walk test (R2 = 0.17) and chair-stand test (R2 = 0.18). Patients' mean the 6-minute walk test decreased at the end of the prehabilitation program, while grip strength and chair-stand test were unchanged. When stratified by low or intermediate and high frailty scores, the differences in the 6-minute walk test and chair-stand test were unchanged. Hospital duration of stay, complications, and 90-day readmission rates were not different between frailty groups (P > .05). CONCLUSION Correlation of physical status measures with frailty score suggests only one of these measures is sufficient to estimate patients' preoperative physical status. A longer, more comprehensive prehabilitation program or an expedited operation are likely the best strategies to improve patient outcomes.
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Affiliation(s)
| | - Julie Ali
- Department of General Surgery, Cleveland Clinic, Cleveland, OH
| | | | | | - Andrew Tang
- Department of General Surgery, Cleveland Clinic, Cleveland, OH
| | - Toms Augustin
- Department of General Surgery, Cleveland Clinic, Cleveland, OH
| | - Daniel Joyce
- Department of General Surgery, Cleveland Clinic, Cleveland, OH
| | - Robert Simon
- Department of General Surgery, Cleveland Clinic, Cleveland, OH
| | - R Matthew Walsh
- Department of General Surgery, Cleveland Clinic, Cleveland, OH.
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Remote Monitoring Model for the Preoperative Prehabilitation Program of Patients Requiring Abdominal Surgery. FUTURE INTERNET 2021. [DOI: 10.3390/fi13050104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Physical fitness and level of activity are considered important factors for patients with cancer undergoing major abdominal surgery. Cancer patients with low fitness capacity are at greater risk of postoperative complications, longer hospital stays, and mortality. One of the main challenges facing both healthcare providers and patients is to improve the patient’s physical fitness within the available short period (four to six weeks) prior to surgery. Supervised and unsupervised physical prehabilitation programs are the most common recommended methods for enhancing postoperative outcomes in patients undergoing abdominal surgery. Due to obstacles such as geographical isolation, many patients have limited access to medical centers and facilities that provide onsite prehabilitation programs. This article presents a review of the literature and the development of a model that can remotely monitor physical activities during the prehabilitation period. The mixed prehabilitation model includes the identification of fundamental parameters of physical activities (type, intensity, frequency, and duration) over time. A mathematical model has been developed to offer a solution for both the healthcare provider and patients. This offers the opportunity for physicians or physiotherapists to monitor patients performing their prescribed physical exercises in real time. The model that has been developed is embedded within the internet of things (IoT) system, which calculates the daily and weekly efforts made by the patients and automatically stores this in a comma-separated values (CSV) file that medical staff can access. In addition, this model allows the patient to compensate for missed prescribed activity by adding additional efforts to meet the prehabilitation requirements. As a result, healthcare staff are provided with feedback on patient engagement in prescribed exercise during the period of the prehabilitation program.
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Tully R, Loughney L, Bolger J, Sorensen J, McAnena O, Collins CG, Carroll PA, Arumugasamy M, Murphy TJ, Robb WB. The effect of a pre- and post-operative exercise programme versus standard care on physical fitness of patients with oesophageal and gastric cancer undergoing neoadjuvant treatment prior to surgery (The PERIOP-OG Trial): Study protocol for a randomised controlled trial. Trials 2020; 21:638. [PMID: 32660526 PMCID: PMC7359259 DOI: 10.1186/s13063-020-04311-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 04/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Advances in peri-operative oncological treatment, surgery and peri-operative care have improved survival for patients with oesophagogastric cancers. Neoadjuvant cancer treatment (NCT) reduces physical fitness, which may reduce both compliance and tolerance of NCT as well as compromising post-operative outcomes. This is particularly detrimental in a patient group where malnutrition is common and surgery is demanding. The aim of this trial is to assess the effect on physical fitness and clinical outcomes of a comprehensive exercise training programme in patients undergoing NCT and surgical resection for oesophagogastric malignancies. METHODS The PERIOP-OG trial is a pragmatic, multi-centre, randomised controlled trial comparing a peri-operative exercise programme with standard care in patients with oesophagogastric cancers treated with NCT and surgery. The intervention group undergo a formal exercise training programme and the usual care group receive standard clinical care (no formal exercise advice). The training programme is initiated at cancer diagnosis, continued during NCT, between NCT and surgery, and resumes after surgery. All participants undergo assessments at baseline, post-NCT, pre-surgery and at 4 and 10 weeks after surgery. The primary endpoint is cardiorespiratory fitness measured by demonstration of a 15% difference in the 6-min walk test assessed at the pre-surgery timepoint. Secondary endpoints include measures of physical health (upper and lower body strength tests), body mass index, frailty, activity behaviour, psychological and health-related quality of life outcomes. Exploratory endpoints include a health economics analysis, assessment of clinical health by post-operative morbidity scores, hospital length of stay, nutritional status, immune and inflammatory markers, and response to NCT. Rates of NCT toxicity, tolerance and compliance will also be assessed. DISCUSSION The PERIOP-OG trial will determine whether, when compared to usual care, exercise training initiated at diagnosis and continued during NCT, between NCT and surgery and then during recovery, can maintain or improve cardiorespiratory fitness and other physical, psychological and clinical health outcomes. This trial will inform both the prescription of exercise regimes as well as the design of a larger prehabilitation and rehabilitation trial to investigate whether exercise in combination with nutritional and psychological interventions elicit greater benefits. TRIAL REGISTRATION ClinicalTrials.gov: NCT03807518 . Registered on 1 January 2019.
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Affiliation(s)
- Roisin Tully
- Department of Upper GI Surgery, Beaumont Hospital, Dublin, Ireland
- The Royal College of Surgeons in Ireland, St. Stephens Green, Dublin, Ireland
| | - Lisa Loughney
- The Royal College of Surgeons in Ireland, St. Stephens Green, Dublin, Ireland
- ExWell Medical, Santry Sports Link, Dublin, Ireland
| | - Jarlath Bolger
- Department of Upper GI Surgery, Beaumont Hospital, Dublin, Ireland
| | - Jan Sorensen
- The Royal College of Surgeons in Ireland, St. Stephens Green, Dublin, Ireland
| | - Oliver McAnena
- Department of Upper GI Surgery, University Hospital, Galway, Ireland
| | - Chris G Collins
- Department of Upper GI Surgery, University Hospital, Galway, Ireland
| | - Paul A Carroll
- Department of Upper GI Surgery, University Hospital, Galway, Ireland
| | - Mayilone Arumugasamy
- Department of Upper GI Surgery, Beaumont Hospital, Dublin, Ireland
- The Royal College of Surgeons in Ireland, St. Stephens Green, Dublin, Ireland
| | - Tomas J Murphy
- Department of Upper GI Surgery, Mercy University Hospital, Cork, Ireland
| | - William B Robb
- Department of Upper GI Surgery, Beaumont Hospital, Dublin, Ireland.
- The Royal College of Surgeons in Ireland, St. Stephens Green, Dublin, Ireland.
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Abstract
OBJECTIVES To recognize cancer prehabilitation as a pretreatment regimen to increase functional status for patients requiring cancer treatment. This article presents current evidence addressing the efficacy and benefits of prehabilitation regimens in different cancer survivor populations. DATA SOURCES Studies and case reports in the PubMed database. CONCLUSION Cancer prehabilitation may improve outcomes. Prehabilitation may include targeted or whole-body exercise, nutrition, education, psychologic counseling, and smoking cessation. Opportunities exist to further improve access to and delivery of multimodal prehabilitation, and nurses play a critical role in connecting patients to these services. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses who are knowledgeable of cancer treatment-related effects are poised to assess survivors for existing impairments, advocate for prehabilitation for existing and potential morbidities, and monitor functional status over time. As patient educators, they are key to informing cancer survivors about the role of prehabilitation.
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Bolger JC, Loughney L, Tully R, Cunningham M, Keogh S, McCaffrey N, Hickey W, Robb WB. Perioperative prehabilitation and rehabilitation in esophagogastric malignancies: a systematic review. Dis Esophagus 2019; 32:5519688. [PMID: 31206582 DOI: 10.1093/dote/doz058] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 04/30/2019] [Accepted: 05/15/2019] [Indexed: 12/11/2022]
Abstract
Cancers of the esophagus and stomach are challenging to treat. With the advent of neoadjuvant therapies, patients frequently have a preoperative window with potential to optimize their status before major resectional surgery. It is unclear as to whether a prehabilitation or optimization program can affect surgical outcomes. This systematic review appraises the current evidence for prehabilitation and rehabilitation in esophagogastric malignancy. A literature search was performed according to PRISMA guidelines using PubMed, EMBASE, Cochrane Library, Google Scholar, and Scopus. Studies including patients undergoing esophagectomy or gastrectomy were included. Studies reporting on at least one of aerobic capacity, muscle strength, quality of life, morbidity, and mortality were included. Twelve studies were identified for inclusion, comprising a total of 937 patients. There was significant heterogeneity between studies, with a variety of interventions, timelines, and outcome measures reported. Inspiratory muscle training (IMT) consistently showed improvements in functional status preoperatively, with three studies showing improvements in respiratory complications with IMT. Postoperative rehabilitation was associated with improved clinical outcomes. There may be a role for prehabilitation among patients undergoing major resectional surgery in esophagogastric malignancy. A large randomized controlled trial is warranted to investigate this further.
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Affiliation(s)
- Jarlath C Bolger
- Beaumont Hospital.,School of Medicine, Royal College of Surgeons in Ireland
| | - Lisa Loughney
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Roisin Tully
- Beaumont Hospital.,School of Medicine, Royal College of Surgeons in Ireland
| | | | | | - Noel McCaffrey
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | | | - William B Robb
- Beaumont Hospital.,School of Medicine, Royal College of Surgeons in Ireland
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van Egmond MA, van der Schaaf M, Klinkenbijl JHG, Twisk JWR, Engelbert RHH, van Berge Henegouwen MI. The pre- and postoperative course of functional status in patients undergoing esophageal cancer surgery. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2019; 46:173-179. [PMID: 31445767 DOI: 10.1016/j.ejso.2019.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 06/03/2019] [Accepted: 08/05/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION To optimally target physiotherapy treatment, knowledge of the pre- and postoperative course of functional status in patients undergoing esophagectomy is required. The aim of this prospective longitudinal study was to investigate the course of functional status in patients with esophageal cancer before and after esophagectomy. MATERIALS AND METHODS Functional status outcome measures of patients with esophageal cancer who underwent surgery between March 2012 and June 2016 were prospectively measured at 3 months and at 1 day before surgery and at 1 week and at 3 months after surgery. Analysis of repeated measurements with the mixed model approach was used to study changes over time. RESULTS Hundred fifty-five patients were measured at 3 months and at 1 day before surgery, of which 109 (70.3%) at 1 week and 60 (38.7%) at 3 months after surgery. Mean (SD) age at surgery was 63.5 years (9.3), and 122 patients (78.7%) were male. The incidence of postoperative complications was 83 (53.5%). Three months postoperatively, functional status measures returned to baseline levels, except from handgrip strength (beta [95% CI] -6.2 [-11.3 to -1.1]; P = 0.02) and fatigue (4.7 [0.7to 8.7]; P = 0.02). No differences were observed in the course of functional status between patients with and without postoperative complications. CONCLUSION Functional status of patients undergoing esophagectomy returned to baseline values three months after surgery, despite the high incidence of postoperative complications. This requires rethinking the concept of prehabilitation, where clearly not all patients benefit from high functional status to prevent postoperative complications.
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Affiliation(s)
- Maarten A van Egmond
- Amsterdam UMC, University of Amsterdam, Department of Rehabilitation, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam University of Applied Sciences, Center of Expertise Urban Vitality, Faculty of Health, Amsterdam, Netherlands; Amsterdam University of Applied Sciences, European School of Physiotherapy, Faculty of Health, Amsterdam, Netherlands.
| | - Marike van der Schaaf
- Amsterdam UMC, University of Amsterdam, Department of Rehabilitation, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam University of Applied Sciences, Center of Expertise Urban Vitality, Faculty of Health, Amsterdam, Netherlands
| | - Jean H G Klinkenbijl
- Gelre Hospital Apeldoorn-Zutphen, Department of Surgery, Apeldoorn, Netherlands; University of Amsterdam, Amsterdam, Netherlands
| | - Jos W R Twisk
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Raoul H H Engelbert
- Amsterdam UMC, University of Amsterdam, Department of Rehabilitation, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam University of Applied Sciences, Center of Expertise Urban Vitality, Faculty of Health, Amsterdam, Netherlands
| | - Mark I van Berge Henegouwen
- Amsterdam UMC, University of Amsterdam, Department of Surgery, Cancer Center Amsterdam, Meibergdreef 9, Amsterdam, Netherlands
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Feasibility of preoperative supervised home-based exercise in older adults undergoing colorectal cancer surgery - A randomized controlled design. PLoS One 2019; 14:e0219158. [PMID: 31265476 PMCID: PMC6605852 DOI: 10.1371/journal.pone.0219158] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 06/12/2019] [Indexed: 12/12/2022] Open
Abstract
Preoperative physical exercise is emerging as a growing field of research globally. There are still challenges in recruiting vulnerable older people, and time constraints in preoperative cancer care to consider. We therefore evaluated the feasibility of short-term supervised home-based exercise in older people prior to colorectal cancer surgery. This feasibility study was conducted between September 2016 and June 2018. People ≥70 years scheduled for colorectal cancer surgery were recruited and randomized to an intervention group receiving supervised home-based physical exercise at a high level of estimated exertion or a standard care group following the standard preoperative path. The exercise (respiratory, strength, and aerobic) consisted of 2–3 supervised sessions a week in the participants’ homes, for at least 2–3 weeks or until surgery, and a self-administered exercise program in between. The primary outcome was process feasibility, including aspects specifically related to recruitment rate, compliance to the intervention, and acceptability. The secondary outcome was scientific feasibility including treatment safety, description of dose level and response, and estimation of treatment results. Twenty-three participants were included (recruitment rate 35%). A median of 6 supervised sessions was conducted over a 17-day exercise period. Compliance with the supervised sessions was 97%, and participants found the intervention acceptable. Concerning the self-administered exercise, a median of 19 inspiratory muscle training, 6 functional strength, and 8.5 aerobic sessions were reported. Challenges reported by program instructors were time constraints and difficulties in achieving high exercise intensities on the Borg CR-10 scale. A statistically significant between-group difference was only found in inspiratory muscle strength, favoring the intervention group (p<0.01). A short-term preoperative supervised home-based physical exercise intervention can be conducted, with respect to compliance and acceptability, in older people with similar physical status as in this study prior to colorectal cancer surgery. However, modifications are warranted with respect to improving recruitment rates and achieving planned intensity levels prior to conducting a definitive trial.
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Topal B, Smelt HJ, Van Helden EV, Celik A, Verseveld M, Smeenk F, Pouwels S. Utility of preoperative exercise therapy in reducing postoperative morbidity after surgery; a clinical overview of current evidence. Expert Rev Cardiovasc Ther 2019; 17:395-412. [DOI: 10.1080/14779072.2019.1625771] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Besir Topal
- Department of Cardiothoracic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | | | - Esmee V. Van Helden
- Department of Surgery, Franciscus Gasthuis & Vlietland, Rotterdam/Schiedam, The Netherlands
| | - Alper Celik
- Department of Metabolic Surgery, Metabolic Surgery Clinic, Sisli, Istanbul, Turkey
| | - Maria Verseveld
- Department of Surgery, Franciscus Gasthuis & Vlietland, Rotterdam/Schiedam, The Netherlands
| | - Frank Smeenk
- Department of Respiratory Medicine, Catharina Hospital, Eindhoven, The Netherlands
- SHE School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| | - Sjaak Pouwels
- Department of Surgery, Franciscus Gasthuis & Vlietland, Rotterdam/Schiedam, The Netherlands
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11
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Zylstra J, Boshier P, Whyte GP, Low DE, Davies AR. Peri-operative patient optimization for oesophageal cancer surgery - From prehabilitation to enhanced recovery. Best Pract Res Clin Gastroenterol 2018; 36-37:61-73. [PMID: 30551858 DOI: 10.1016/j.bpg.2018.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 11/19/2018] [Indexed: 02/08/2023]
Affiliation(s)
- J Zylstra
- Department of Gastrointestinal Medicine and Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK; School of Sport and Exercise Science, Faculty of Science, Liverpool John Moore's University, Liverpool, UK
| | - P Boshier
- Virginia Mason Medical Centre, Seattle, USA
| | - G P Whyte
- School of Sport and Exercise Science, Faculty of Science, Liverpool John Moore's University, Liverpool, UK; Research Institute for Sport & Exercise Science, Liverpool John Moore's University, UK
| | - D E Low
- Virginia Mason Medical Centre, Seattle, USA
| | - A R Davies
- Department of Gastrointestinal Medicine and Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK; Division of Cancer Studies, King's College London, UK.
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12
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Singh B, Spence RR, Steele ML, Sandler CX, Peake JM, Hayes SC. A Systematic Review and Meta-Analysis of the Safety, Feasibility, and Effect of Exercise in Women With Stage II+ Breast Cancer. Arch Phys Med Rehabil 2018; 99:2621-2636. [PMID: 29730319 DOI: 10.1016/j.apmr.2018.03.026] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/24/2018] [Accepted: 03/23/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To systematically evaluate the safety, feasibility, and effect of exercise among women with stage II+ breast cancer. DATA SOURCES CINAHL, Cochrane, Ebscohost, MEDLINE, Pubmed, ProQuest Health and Medical Complete, ProQuest Nursing and Allied Health Source, Science Direct and SPORTDiscus were searched for articles published before March 1, 2017. STUDY SELECTION Randomized, controlled, exercise trials involving at least 50% of women diagnosed with stage II+ breast cancer were included. DATA EXTRACTION Risk of bias was assessed and adverse event severity was classified using the Common Terminology Criteria. Feasibility was evaluated by computing median (range) recruitment, withdrawal, and adherence rates. Meta-analyses were performed to evaluate exercise safety and effects on health outcomes only. The influence of intervention characteristics (mode, supervision, duration and timing) on exercise outcomes were also explored. DATA SYNTHESIS There were no differences in adverse events between exercise and usual care (risk difference: <0.01 ([95% CI: -0.01, 0.01], P=0.38). Median recruitment rate was 56% (1%-96%), withdrawal rate was 10% (0%-41%) and adherence rate was 82% (44%-99%). Safety and feasibility outcomes were similar, irrespective of exercise mode, supervision, duration, or timing. Effects of exercise for quality of life, fitness, fatigue, strength, anxiety, depression, body mass index and waist circumference compared with usual care were significant (standardized mean difference range: 0.17-0.77, P<0.05). CONCLUSION The findings support the safety, feasibility, and effects of exercise for those with stage II+ breast cancer, suggesting that national and international exercise guidelines appear generalizable to women with local, regional, and distant breast cancer.
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Affiliation(s)
- Ben Singh
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Musk Avenue, Kelvin Grove, Queensland, Australia.
| | - Rosalind R Spence
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Musk Avenue, Kelvin Grove, Queensland, Australia
| | - Megan L Steele
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Musk Avenue, Kelvin Grove, Queensland, Australia
| | - Carolina X Sandler
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Musk Avenue, Kelvin Grove, Queensland, Australia; Cancer Prevention Research Centre, School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Jonathan M Peake
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Musk Avenue, Kelvin Grove, Queensland, Australia; School of Biomedical Sciences, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland, Australia
| | - Sandra C Hayes
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Musk Avenue, Kelvin Grove, Queensland, Australia
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13
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Carmichael JC, Keller DS, Baldini G, Bordeianou L, Weiss E, Lee L, Boutros M, McClane J, Steele SR, Feldman LS. Clinical practice guideline for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons (ASCRS) and Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Surg Endosc 2017; 31:3412-3436. [DOI: 10.1007/s00464-017-5722-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 07/10/2017] [Indexed: 12/16/2022]
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14
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Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons. Dis Colon Rectum 2017; 60:761-784. [PMID: 28682962 DOI: 10.1097/dcr.0000000000000883] [Citation(s) in RCA: 267] [Impact Index Per Article: 38.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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