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Is it possible to use home-based prehabilitation with added E-health in patients with colorectal cancer undergoing surgery?

ABSTRACT: Background and study aims Colorectal cancer is the third most common type of cancer worldwide, with the majority of the patients being >70 years of age. The main treatment, surgery, is associated with a high number of complications. Furthermore, many patients experience loss of quality of life after surgical treatment. Prehabilitation, optimization of a patient’s health status between diagnosis and major surgical intervention, seems to be effective in improving fitness. There are indications that a prehabilitation program that is personalized to the needs of a patient is most effective. Furthermore, a home-based prehabilitation program probably has the least impact on the patient’s life and is less demanding for high-risk patients (i.e. patients with low aerobic fitness), especially in the emotionally stressful period between diagnosis and surgery. On the other hand, supervision might be necessary to motivate and stimulate patients during their exercise routine. With modern technologies, already used in cardio-rehabilitation, such as teleprehabilitation, it is possible to monitor an exercise program remotely while the patient performs his training at home. The primary aim of this study is to investigate the feasibility of a home-based teleprehabilitation program in high-risk patients scheduled for cancer surgery. Who can participate? Adults over 18 years, with colorectal cancer requiring surgical treatment. What does the study involve? Participants are offered a teleprehabilitation program as part of their routine care in the weeks before surgery.

DISEASE(S): Prehabilitation Of Patients With Colorectal Cancer

PROVIDER: 2421262 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Interventions: Eligible participants will be prescribed an exercise program for a period of six weeks or up until surgery (whichever is earlier). Exercise prescriptions will be individualized to a participant’s prior aerobic fitness, medical comorbidities, response to any prior treatment and any immediate negative treatment effects of prior treatment (such as ongoing neuropathy and/or cancer cachexia) as per the ACSM Guidelines for exercise prescription. Exercise programs will be conducted one-on-one either in person in a hospital-based gym or unsupervised within the home environment based on the patient’s preference and ability to travel to the hospital. Exercise programs will be moderate to vigorous intensity as rated by the Borg RPE rating scale and prescribed in conjunction with cardiopulmonary exercise testing results. Exercise programs will include at least 3x30min aerobic exercise (walking/cycling/swimming) and 2x30min resistance sessions (upper and lower body strengthening exercises e.g. sit to stand, step ups, shoulder press) per week based on whether participants are meeting the ACSM exercise prescription guidelines at baseline. Participants will also be provided with a respiratory education session including information regarding breathing exercises to complete in the lead up to surgery. Given the complexity of this patient sample exercise prescription will also be adapted upon previous musculoskeletal injuries/issues (e.g. previous total joint replacements) and patients exercise preferences, to increase adherence with six-week program. Exercise programs will be progressed by a qualified physiotherapist and/or exercise physiologist based on participant’s response to exercise and compliance with the exercise program. The 30 min respiratory ed Primary outcome(s): Feasibility of delivering a six week individualized Exercise Prehabilitation Program amongst high risk surgical patients presenting for major cancer surgery. Feasibility of the program will be defined as: •Percentage of patients consenting to the exercise program = >70% consent rate •>70% adherence to exercise prescribed, as determined by participant exercise diaries •>85% retention in the study (Measures of non-compliance including dropout rates and reasons for drop out) •Intervention acceptability to patients •Cost of resources to run the study [Prior to surgery] Study Design: Purpose: Treatment; Allocation: Non-randomised trial; Type of endpoint: Safety/efficacy

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Is it possible to use home-based prehabilitation with added E-health in patients with colorectal cancer undergoing surgery?

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