Exercise prehabilitation program for patients under neoadjuvant treatment for rectal cancer: A pilot study
Lidia B Alejo1, Itziar Pagola-Aldazabal1, Carmen Fiuza-Luces2, Daniel Huerga3, María Victoria de Torres4, Ana Soria Verdugo4, María Jesus Ortega Solano4, José Luis Felipe5, Alejandro Lucia1, Ana Ruiz-Casado6
1 School of Sports Sciences, European University of Madrid; Research in Physical Activity and Health, Research Institute “i+12” (12 Octubre University Hospital), Madrid, Spain
2 Research in Physical Activity and Health, Research Institute “i+12” (12 Octubre University Hospital), Madrid, Spain
3 Department of Surgery, Fuenlabrada University Hospital, Madrid, Spain
4 Department of Oncology, Fuenlabrada University Hospital, Madrid, Spain
5 School of Sports Sciences, European University of Madrid, Madrid, Spain
6 Department of Oncology, Puerta de Hierrro University Hospital, Majadahonda, Spain
Prof. Alejandro Lucia
European University of Madrid, 28670 Villaviciosa De Odón, Madrid
Source of Support: None, Conflict of Interest: None
Context: Prehabilitation is emerging as a method of preparing patients physically and mentally for the often disabling effects of cancer treatment.
Aims: This study aims to assess the feasibility and to explore the potential effects of a prehabilitation program consisting of educational physical exercise sessions in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy treatment (NCRT).
Settings and Design: This was a pilot study with 12 patients (3 males and 9 females, age 61 ± 7 years).
Subjects and Methods: The program included six educational sessions of exercise during NCRT. Adherence to the intervention; quality of life (QoL); anxiety and depression; body mass index; physical fitness (peak oxygen uptake (VO2peak), handgrip and dynamic leg strength); and physical activity (PA) levels were measured.
Statistical Analysis Used: Data are reported as the mean ± standard deviation or medians and interquartile ranges for questionnaire-derived data. Secondary outcome measures were compared using the nonparametric Wilcoxon test. The threshold P value for significance was calculated after correction for multiple comparisons using the Bonferroni method.
Results: Adherence to the program was 64 of 72 possible exercise education sessions completed, i.e., 89%. We detected a trend toward a significant improvement in VO2peak after the intervention (P = 0.015), together with reduced scores for both depression (P = 0.017) and the QoL domain “emotional function” (P = 0.027). Mean levels of moderate to vigorous PA tended to increase after the exercise program (P = 0.091).
Conclusions: Exercise might be an effective prehabilitation strategy for surgery during the period of NCRT.