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Adherence to Pre-operative Exercise and the Response to Prehabilitation in Oesophageal Cancer Patients
Halliday, Laura Doganay, Emre Winter-Blyth, Venetia Osbourne, Hayley Buckley, John Moorthy, Krishna
Halliday, Laura
Doganay, Emre
Winter-Blyth, Venetia
Osbourne, Hayley
Buckley, John
Moorthy, Krishna
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Other Contributors
EPub Date
Publication Date
2020-04-20
Submitted Date
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Abstract
BACKGROUND:
Prehabilitation is thought to reduce post-operative respiratory complications by optimising fitness before surgery. This prospective, single-centre study aimed to establish the effect of pre-operative exercise on cardiorespiratory fitness in oesophageal cancer patients and characterise the effect of adherence and weekly physical activity on response to prehabilitation.
METHODS:
Patients received a personalised, home-based pre-operative exercise programme and self-reported their adherence each week. Cardiorespiratory fitness (pVO2max and O2 pulse) was assessed at diagnosis, following completion of neoadjuvant chemotherapy (NAC) and immediately before surgery. Study outcomes included changes in fitness and post-operative pneumonia.
RESULTS:
Sixty-seven patients with oesophageal cancer underwent prehabilitation followed by surgery between January 2016 and December 2018. Fitness was preserved during NAC and then increased prior to surgery (pV02max Δ = +2.6 ml min-1, 95% CI 1.2-4.0 p = 0.001; O2 pulse Δ = +1.4 ml beat-1 95% CI 0.5-2.3 p = 0.001). Patients with higher baseline fitness completed more physical activity. Regression analyses found adherence was associated with improvement in fitness immediately before surgery (p = 0.048), and the amount of physical activity completed was associated with the risk of post-operative pneumonia (p = 0.035).
CONCLUSION:
Pre-operative exercise can maintain cardiorespiratory fitness during NAC and facilitate an increase in fitness before surgery. Greater exercise volumes were associated with a lower risk of post-operative pneumonia, highlighting the importance progressing exercise programmes throughout prehabilitation. Patients with high baseline fitness completed more physical activity and may require less supervision to reach their exercise goals. Further research is needed to explore stratified approaches to prehabilitation.
KEYWORDS:
Exercise therapy; Oesophageal cancer; Pre-operative care; Surgery
Citation
Halliday, L. J., Doganay, E., Wynter-Blyth, V., Osborn, H., Buckley, J., & Moorthy, K. (2021). Adherence to pre-operative exercise and the response to prehabilitation in oesophageal cancer patients. Journal of Gastrointestinal Surgery, 25, 890-899. https://doi.org/10.1007/s11605-020-04561-2
Publisher
Springer
Journal
Journal of Gastrointestinal Surgery
Research Unit
DOI
10.1007/s11605-020-04561-2
PubMed ID
PubMed Central ID
Type
Article
Language
Description
Series/Report no.
ISSN
1091-255X
EISSN
1873-4626