Pre-surgery aerobic and resistance exercise for rectal cancer patients.

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 undertaken. This included such specific activity as walking or jogging on a treadmill; cycling or rowing on a stationary ergometer; or exercising on a cross training machine depending on each patient’s preference. The target intensity was 60 – 80% of the estimated HRmax (220 – age in years) measured using heart rate monitors. The design criteria for the exercise intervention programme were to optimise the stimulus to the cardiovascular and neuromuscular systems while maximising compliance and retention. All sessions were conducted with one-on-one supervision by a qualified and accredited exercise physiologist who ensured safety and adherence to correct lifting techniques. Each session concluded with a 5-minute cool-down with stretching activities similar to the warm-up. Patients were provided with a session log in which to record their attendance, exercise weights, repetitions and sets.