None listed
Conditions
Brief summary
The primary purpose of this feasibility pilot study is to examine the efficacy of an exercise regime and dietary advice prior to colorectal surgery in frail older adults. Who is it for? You may be eligible to participate in this study if you are aged 50 years or older, are considered frail, and are scheduled to undergo major colorectal surgery. You will also need to be willing and able to attend exercise and dietary advice sessions in the Townsville area. Study details Participants in this study will be randomly allocated (by chance) to receive either usual care prior to their surgery, or to receive a tailored exercise regime from exercise physiologists. Regimes will be tailored to each individual's level of fitness and health, but will all include elements of strength, aerobic and balance training to be carried out during a maximum of three, 1-hour sessions per week for 4 weeks. It is hoped that the findings of this pilot study will inform researchers primarily as to whether the exercise and dietary advice intervention is feasible and effective in this patient group.
Interventions
Preoperative tailored regimen of exercise with dietary advice.
Exercise will involve up to 12 sessions (maximum of three, 1-hour, small group sessions per week for 4 weeks supervised by an accredited exercise physiologist) of combined strength/cardiovascular/balance exercise in the 4 weeks prior to surgery.
Each exercise session will consist of:
- 5 mins warm-up (treadmill/mobility)
- 30 mins of circuit based combined strength/cardiovascular & balance exercises as follows = 2 sets of 8-12 reps
Preoperative tailored regimen of exercise with dietary advice. Exercise will involve up to 12 sessions (maximum of three, 1-hour, small group sessions per week for 4 weeks supervised by an accredited exercise physiologist) of combined strength/cardiovascular/balance exercise in the 4 weeks prior to surgery. Each exercise session will consist of: - 5 mins warm-up (treadmill/mobility) - 30 mins of circuit based combined strength/cardiovascular & balance exercises as follows = 2 sets of 8-12 reps per exercise (50% of predicted 1RM) of chest press, seated row, bicep curl, triceps extension, squat, & leg curl; AND 3-4 sets (1 min per round) of single leg balance (eyes open/closed) - 20 mins of aerobic interval exercise (walking) based of high and low intensity at a ratio of 1:1 (1 min of higher intensity exercise [e.g. 50% heart rate reserve] interspersed with 1 min of lower intensity [e.g. 25% heart rate reserve] - 5 mins cool down (treadmill/mobility) Generic dietary advice will involve a single 1-hour, one-on-one educational session with a allied health professional. All participants will maintain a diary of all exercise activities during the study.
Sponsors
Dr Siva Senthuran
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator)
Eligibility
Sex/Gender
All
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients undergoing all major colorectal surgery (both cancer and non cancer) Frail or Prefrail by Edmonton Frail Scale (>3 criteria) Residents capable of attending training & assessments.
Exclusion criteria
Emergent or Urgent Surgery (<30 days wait) Contraindications to Prehabilitation such as: - Unstable Angina - Resting Systolic BP>200 or Diastolic BP>110 - Orthostatic BP drop >20mmHg - Critical aortic stenosis (Peak systolic pressure gradient >50mmHg with an aortic valve orifice area <0.75cm2 in average adult) - Acute systemic illness or fever - Uncontrolled Atrial or Ventricular arrhythmias - Uncontrolled Sinus tachycardia - Uncompensated congestive heart failure - 3rd Degree AV Block (without pacemaker) - Active Pericarditis or Myocarditis - Recent Thromboembolism - Uncontrolled Diabetes (Resting BSL >22mmol) - Other metabolic conditions e.g. acute thyroiditis Severe Orthopaedic conditions prohibiting exercise Inability to speak English or has documented learning impairment
Outcome results
None listed