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Feasibility and acceptability of pre-operative exercise to improve patient outcomes after major pelvic cancer surgery: A pilot randomised controlled trial.

ABSTRACT: Interventions: Pre-operative exercise programme: The exercise programme will consist of 60 minutes individualised (one-to-one) training session with a registered physiotherapist, once a week, for 2 to 6 weeks (maximal of 6 sessions) before the patient undergoes their scheduled surgery. The last day of exercise will be the day before the patient undergoes surgery. The duration (2-6 weeks), specific exercises performed and intensity of the exercise programme will all be tailored to each patient through a health assessment, taking into consideration their current health status, physical activity level, co-morbidities and medical history. Each session will consist of 10 minutes of warm-up (walking and cycling), 40 minutes of aerobic and endurance exercises (such as cycling, treadmill and rower activity), respiratory and muscle strength exercises (breathing and weights training), and 10 minutes cool down (stretches and flexibility exercises). The aerobic and endurance exercises will be performed at 40% to 60% of the maximum heart rate and the strength training will be performed at an intensity of 40% to 60% of the one repetition maximum. Participant will be given instruction and recommendations on how to complete and progress these exercises (or similar exercises) at home (4 sessions x 60 minutes at home per week, up to the scheduled date of surgery). Furthermore, apart from the prescribed exercises, participants will be recommended to engage in moderate-intensity exercise for at least 150 minutes per week (such as walking or cycling). Home exercises will be captured in a daily exercise diary that participants will complete until the end of the exercise programme. Primary outcome(s): The feasibility of incorporating a standardised, intensive exercise programme into the pre-operative period for patients undergoing pelvic exenteration at Royal Prince Alfred Hospital. This will be determined by the number of eligible patients recruited, retention and adherence rates to the exercise programme. The retention rate will be defined as the percentage of individuals who completed the intervention. Adherence will be defined as the percentage of exercise sessions attended by those who were randomised to the intervention group. Adherence to the exercise programme will be recorded using attendance records (recorded by the study physiotherapist) / participant exercise diaries (recorded by the participant).[Feasibility will be assessed during the week before surgery (1 week pre-operative), ];The acceptability of incorporating a standardised, intensive exercise programme into the pre-operative period for patients undergoing pelvic exenteration at Royal Prince Alfred Hospital. This will be assessed by a semi structured questionnaire pre-discharge.[Acceptability will be assessed shortly before discharge after surgery (pre-hospital discharge).];The acceptability to patients of being randomised to the exercise program or usual care (satisfaction with study intervention). This will be determined by the number or eligible patients recruited to the trial (who accept being randomised to either treatment group), and by a semi structured questionnaire pre-discharge.[Acceptability of randomisation and patient satisfaction with the study intervention will be assessed at enrollment to the study and at pre-hospital discharge.] Study Design: Purpose: Treatment; Allocation: Randomised controlled trial; Masking: Blinded (masking used);Assignment: Parallel;Type of endpoint: Efficacy

DISEASE(S): Cancer-ovarian And Primary Peritoneal,Cancer-bowel-back Passage (rectum) Or Large Bowel (colon),Cancer-other Cancer Types,Pelvic Cancer

PROVIDER: 2465895 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Interventions: This study was a 16-week exercise intervention programme done prior to surgery with assessments undertaken at three time-points: (1) baseline, (2) immediately pre-surgery and (3) 8-week post-surgery follow-up. This is a 16 weeks exercise programme that commenced prior to the schedule surgery. Patients undertook an exercise programme that consisted of two supervised clinic sessions per week. Each supervised exercise session took approximately 60 minutes to complete. Sessions commenced with a 5-minute warm-up consisting of moderate level of aerobic exercise (~60% heart rate maximum (HRmax)), as well as stretching exercises of the major muscle groups: chest, shoulder, biceps, triceps, quadriceps, hamstrings and calf muscles. This was followed by a resistance-training regime that included a series of six exercises targeting the major muscles of the upper- and lower-body. Upper-limb exercises included chest press, seated row and lat pull-down. Lower-limb exercises were leg extension, leg curl and leg press. All exercises were performed through the full range of motion adhering to correct techniques. To ensure the progressive nature of the training programme, patients were encouraged to work past the repetition maximum (RM) prescribed, with resistance increased by 5 – 10% for the subsequent set/training sessions if they were able to exceed the number specified. Progression of resistance followed guidelines previously outlined by Galvao and Newton (2005). The training phases were as follows: week 1 – 2 (two sets 12 RM), week 3 – 5 (three sets of 10 RM), week 6 – 8 (three sets of 8 RM), and week 9 – 10 (four sets of 6 RM). After week 10, the training phases set in week 1 – 2 were resumed to implement a periodised exercise model. A further 20 minutes of aerobic exercise was unde Primary outcome(s): The primary objective of this feasibility study was to determine the efficacy of a supervised, pre-surgical exercise programme consisting of targeted resistance and aerobic training for rectal cancer patients scheduled to received rectal resection surgery. Specifically, we aimed to investigate the effects of a pre-surgical exercise intervention on neuromuscular strength using the one-repetition maximum chest press, leg press, seated row and leg extension exercise protocol[Baseline, pre-surgery and 8-weeks post-surgery] Study Design: Purpose: Prevention; Allocation: Non-randomised trial

Project description:The goal of the endurance exercise training study in young adult rats was to perform exercise training studies in young adult (6-month-old) F344 rats, and from these rats collect multiple tissues in order to provide high quality samples for detailed analysis by chemical analysis sites. Tissues were collected from 10-12 rats sedentary control rats concurrent with the collection of the 8-week training groups. The 8-week training group and controls were from the same cohort and same age at euthanasia. For the older age group, an additional set of controls (n=5-6) were collected with the 1-2 week training group. Rats were either sedentary or underwent an exercise training program. Rats were exercised on the rodent treadmill 5 days per week using a progressive training protocol designed to exercise the rats at approximately 70% of VO2max and training was performed no earlier than 10:00 am and no later than 5:00 pm over 5 consecutive days per week. Training was initiated with the treadmill set at 70% of VO2 max and 5 degrees grade for 20 minutes. The duration of exercise was increased by one minute each day until day 31 of training (start of week 7), when a duration of 50 min was reached. Speed and grade of each training session increased in larger increments due to treadmill parameters. The highest intensity and duration of training began on day 31. This intensity was maintained for the final 10 days of the protocol to ensure steady state had been achieved. If any rats were unable to perform at least 4 days of training per week they were removed from the study and euthanized. It is important to note that the starting treadmill speed varied depending on the sex and age of the rat. The initial and maximum speeds were based on VO2max measurements obtained during the pre-training testing of the compliant rats. Rats assigned to the control group followed a schedule similar to the training group. They were placed in one lane on the treadmill for 15 minutes/day, 5 days per week. The treadmill was set at 0 m/min at an incline that corresponded to the incline being used by the training group.

Project description:The goal of the endurance exercise training study in young adult rats was to perform exercise training studies in young adult (6-month-old month) F344 rats, and from these rats collect multiple tissues in order to provide high quality samples for detailed analysis by chemical analysis sites. Tissues were collected from 10-12 rats sedentary control rats concurrent with the collection of the 8-week training groups. The 8-week training group and controls were from the same cohort and same age at euthanasia. For the older age group, an additional set of controls (n=5-6) were collected with the 1-2 week training group. Rats were either sedentary or underwent an exercise training program. Rats were exercised on the rodent treadmill 5 days per week using a progressive training protocol designed to exercise the rats at approximately 70% of VO2max and training was performed no earlier than 10:00 am and no later than 5:00 pm over 5 consecutive days per week. Training was initiated with the treadmill set at 70% of VO2 max and 5 degrees grade for 20 minutes. The duration of exercise was increased by one minute each day until day 31 of training (start of week 7), when a duration of 50 min was reached. Speed and grade of each training session increased in larger increments due to treadmill parameters. The highest intensity and duration of training began on day 31. This intensity was maintained for the final 10 days of the protocol to ensure steady state had been achieved. If any rats were unable to perform at least 4 days of training per week they were removed from the study and euthanized. It is important to note that the starting treadmill speed varied depending on the sex and age of the rat. The initial and maximum speeds were based on VO2max measurements obtained during the pre-training testing of the compliant rats. Rats assigned to the control group followed a schedule similar to the training group. They were placed in one lane on the treadmill for 15 minutes/day, 5 days per week. The treadmill was set at 0 m/min at an incline that corresponded to the incline being used by the training group.

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Feasibility and acceptability of pre-operative exercise to improve patient outcomes after major pelvic cancer surgery: A pilot randomised controlled trial.

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