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Prehabilitation in Colorectal Cancer

ABSTRACT: Objectives To investigate the impact of tele-supervised prehabilitation on functional capacity in colon cancer patients undergoing colorectal resection for cancer and to evaluate the effects of prehabilitation on muscle strength and endurance, quality of life (QoL), executive functions, fatigue and inflammatory and metabolic parameters. Methods A randomized controlled trial will be conducted. Patients will be randomised into either a prehabilitation group or a control group. The prehabilitation group will receive tele-supervised prehabilitation for 4weeks and telerehabilitation for 8weeks post-surgery while control group will begin telerehabilitation only after surgery for 8weeks. Patients will care with an enhanced recovery pathway. Telerehabilitation pre and post-surgery will consist of three moderate-intensity aerobic and resistance sessions per week. Subjects will be assessed at baseline, pre-intervention, post-intervention and post-rehabilitation. The primary outcome will be functional capacity measured using the 6-min walk test. The secondary outcomes will be: physical measurement, quality of life, level of physical activity, executive functions, fatigue, body composition, blood test, energy expenditure.

DISEASE(S): Colon Cancer,Colorectal Neoplasms

PROVIDER: 2240063 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Individuals affected by post-covid condition (PCC) show an increased fatigue and the so-called post-exertion malaise (PEM) that led health professionals to advise against exercise although accumulating evidence indicate the contrary. The goal of this study is to determine the impact of a closely monitored 8-week mixed exercise program on physical capacity, symptoms, fatigue, systemic oxidative stress and plasma proteomic profiles of PCC cases. Methods: Twenty-five women and men with PCC assigned sequentially to exercise (n = 15) and non-exercise (n = 10) groups. Individuals with no PCC served as a control group. The exercise program included cardiovascular and resistance exercises. Physical capacity, physical activity level and the presence of common PCC symptoms were measured before and after the intervention. Fatigue was measured the day following each exercise session. Plasma and PBMC samples were collected at the beginning and end of the training program. Glutathione and deoxyguanosine levels in PBMC and plasma proteomic profiles were evaluated. Results: Bicep Curl (p=0.040) and STS-30 (p=0.043) improved to a greater extent in the exercise group than in the non-exercise group. An interaction effect was also observed for the level of physical activity (p=0.007) with a positive effect of the program on their daily functioning and without any adverse effects on general or post-effort fatigue. Glutathione levels showed marked improvement after exercise. Discernable changes were observed in the plasma proteomics profile with certain proteins involved in inflammatory response (SA100A8) decreasing in the exercise group. Conclusion: Supervised exercise adapted to the level of fatigue and ability is safe and effective in PCC patients in improving their general physical capacity and wellbeing. Systemic molecular markers that accompany physical improvement can be monitored by analyzing plasma proteomics and markers of oxidative stress. Large-scale studies will help identify promising molecular markers to objectively monitor patient improvement.

Project description:Interventions: Study setting- The study will be conducted at the Surgical Professorial Unit of Colombo South Teaching Hospital. Method of randomization- • Following consent, participants will be randomized 1:1 using a random number table to the intervention group or control group with stratification by gender and age group. •The research associate (who will be responsible for patient consent) will be blinded to group allocation. Description of mindfulness based tromodal prehabilitation intervention • The multidisciplinary Mindfulnes-Based trimodal prehabilitation program is composed of four (04) elements: 1. Exercise program 2. Nutritional intervention 3. Psychological coping 4. Mindfulness Protocol • The exact interventions are described in detail below: Exercise program • Patients will be asked to perform unsupervised exercises 4 days a week for 30 minutes per session. • The exercise regime will comprise of 5 min warm-up exercises, 20 min aerobic exercises and 5 min cool down exercises. • A personalized trainer will evaluate the patient and after discussing with the patient and their families will come up with an individualized exercise plan for the patients based on their physical capacity and resources. • They will also be given a DVD containing videos of the exercises performed by a trained personal giving instruction to the patient to follow. • Patients will be given a chart to fill once completing their exercise regime daily. Nutrition intervention • The patients enrolled in the prehabilitation program will be evaluated by a qualified nutritionist during the first visit, Aasubjective global assessment will be used to assess each patients’ nutritional status and requirements and an appropr Primary outcome(s): Functional recovery using the Six-Minute Walk Test (6MWT, Pulse Rate (PR), Blood Pressure (BP) and Oxygen Saturation (SpO2) [1. At the start of the trial 2. Four weeks after prehabilitation or Before the surgery 3. 4-Weeks post-operatively 4. 8-Weeks post-operatively ] Study Design: Randomized controlled trial

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Prehabilitation in Colorectal Cancer

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