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High-Intensity Interval vs. Moderate Continuous Training in Surgical Prehabilitation.

ABSTRACT: Surgery is a stressful procedure associate with perioperative physical impairment. In a previous study, the investigators showed that physical fitness could be optimize in surgical patients using prehabilitation, a preoperative conditioning intervention in form of exercise, nutrition and relaxation technique. The best modality of exercise has yet to be known.The purpose of this study is to compare high interval (HIT) vs. moderate continuous intensity (MC) training, integrated in a prehabilitation intervention in colorectal surgical patients.

DISEASE(S): Colorectal Cancer,Colorectal Neoplasms

PROVIDER: 2260347 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:<p>Thoroughbred (TB) racehorses are subjected to rigorous conditioning programs involving exercise sessions of various types, distances and intensities. These programs aim to optimize both their physical and mental capabilities, which are essential to achieve maximal performance. Conventional investigations of exercise-induced metabolic responses typically focus on a limited set of targeted hematological and biochemical parameters. This field study was conducted to comprehensively assess the metabolic responses triggered by exercise sessions routinely used in TB conditioning. To accomplish this, we employed an untargeted metabolomics approach. Blood samples were collected from 10 racehorses at rest and after completing a routine exercise session. The population was subsequently divided into two groups based on the intensity of the exercise performed: a high-intensity group (n = 6, gallop at ± 13.38 m/s, 1400 m) and a moderate-intensity group (n = 4, soft canter at ± 7.63 m/s, 2500 m). The exercise intensity was evaluated through monitoring of speed, heart rate, and targeted hematological and biochemical parameters (e.g., lactatemia, hematocrit, etc). Resting and 30 min post-exercise plasma samples were analyzed using an untargeted metabolomics approach based on ultra-performance liquid chromatography coupled with high-resolution mass spectrometry. Unsupervised principal component analysis revealed changes in the metabolome from pre- to post-exercise samples with greater alterations following high-intensity exercise. 54 metabolites, mainly related to amino acid, fatty acid, nucleic acid and vitamin metabolism, were altered following high-intensity exercise versus 23 metabolites, mainly related to fatty acid and amino acid metabolism, following moderate-intensity exercise. Untargeted metabolomics complemented the routine biochemical analyses, allowing a more comprehensive exploration of the exercise-induced response to exercises used in routine conditioning. As previously reported by traditional biochemistry, exercise-induced changes in energy metabolism in TB racehorses have been confirmed. Through metabolomics, the involvement of lipid and amino acid metabolism during routine exercise and recovery has been highlighted, aspects that had previously been largely overlooked in Thoroughbred racehorses.</p>

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

Project description:The thalamus may be the critical brain area involved in sensory gating and the relay of respiratory mechanical information to the cerebral cortex for the conscious awareness of breathing. We hypothesized that respiratory mechanical stimuli in the form of tracheal occlusions would modulate the gene expression profile of the thalamus. Specifically, it was reasoned that conditioning to the respiratory loading would induce a state change in the medial thalamus consistent with a change in sensory gating and the activation of molecular pathways associated with learning and memory. In addition, respiratory loading is stressful and thus should elicit changes in gene expressions related to stress, anxiety, and depression. Rats were instrumented with inflatable tracheal cuffs. Following surgical recovery, they underwent ten days (5 days/week) of transient tracheal occlusion conditioning. On day 10, the animals were sacrificed and the brains removed. The medial thalamus was dissected and microarray analysis of gene expression performed. Tracheal obstruction conditioning modulated a total of 661 genes (p < 0.05, log2 fold change ≥ 0.58), 250 genes were down-regulated and 411 up-regulated. There was a significant down-regulation of GAD1, GAD2 and HTR1A, HTR2A genes. CCK, PRKCG, mGluR4, and KCJN9 genes were significantly up-regulated. Some of these genes have been associated with anxiety and depression, while others have been shown to play a role in switching between tonic and burst firing modes in the thalamus and thus may be involved in gating of the respiratory stimuli. Furthermore, gene ontology and pathway analysis showed a significant modulation of learning and memory pathways. These results support the hypothesis that the medial thalamus is involved in the respiratory sensory neural pathway due to the state change of its gene expression profile following repeated tracheal occlusions. Four experimental animals that received tracheal occlusions and four surgical control animals were used. A reference design was used to compare all samples.

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High-Intensity Interval vs. Moderate Continuous Training in Surgical Prehabilitation.

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