None listed
Conditions
Brief summary
This research project aims to explore whether i) introducing regular exercise consultations from physiotherapists before and after colorectal cancer surgery and ii) allowing patients to choose when they want to participate in a formal exercise program is feasible and beneficial. Who is it for? You may be eligible for this study if you are an adult who has been diagnosed with stages I-III colorectal cancer and is within 6 weeks of planned primary tumour resection surgery for colorectal cancer at Eastern Health. Study details Participants will be randomly assigned to receive either three physiotherapist-led exercise consultations inclusive of an exercise assessment, delivered at key times of their cancer care pathway, or the usual care that people currently receive. Data on feasibility, acceptability, physical activity and health-related quality of life will be collected at key timepoints during the trial. It is hoped that findings from this study will help researchers understand how and when exercise support should be offered to people undergoing treatment for colorectal cancer in the future.
Interventions
Participants randomised to the experimental group will receive physiotherapist-led exercise consultation at key times before and after surgery in addition to usual care.
The intervention is designed to establish safe, appropriate and timely engagement with exercise before, during and after colorectal cancer surgery. This intervention is guided by existing frameworks such as the CaReR framework (Cancer Rehabilitation to Recreation) that recommends supporting people with cancer to increase physic
Participants randomised to the experimental group will receive physiotherapist-led exercise consultation at key times before and after surgery in addition to usual care. The intervention is designed to establish safe, appropriate and timely engagement with exercise before, during and after colorectal cancer surgery. This intervention is guided by existing frameworks such as the CaReR framework (Cancer Rehabilitation to Recreation) that recommends supporting people with cancer to increase physical activity through tailored, step-based care across the cancer continuum, with counselling integrated throughout and the level of exercise support provided based on individual needs (Dennett AM, Peiris CL, Shields N, Taylor NF. From Cancer Rehabilitation to Recreation: A Coordinated Approach to Increasing Physical Activity. Phys Ther. 2020;100(11):2049-2059. doi:10.1093/ptj/pzaa135). Structured Exercise Consultations: Participants will receive three physiotherapist-led exercise consultations inclusive of an exercise assessment, delivered at key times of their cancer care pathway. The exercise assessment will be tailored to the participant’s stage of care and will include: • Review of medical history, surgical status, cancer treatment status, and any current symptoms (e.g. pain, fatigue, bowel symptoms) • Screening for precautions or contraindications to exercise and physical activity • Assessment of current physical activity levels and exercise history • Objective measures of function and exercise tolerance as clinically appropriate including but not limited to 6-minute walk test, 5 times sit to stand, mobility, balance, strength, and aerobic capacity, and physiological observations including heart rate, SPO2, blood pressure etc. • Discussion of participant goals, preferences, barriers, and readiness to engage in exercise The findings from the assessment will be used to guide individualised exercise advice and recommendations provided in the exercise consultations that are safe and appropriate for the participant’s clinical status. Personalised Exercise Support and Program Options: During each consultation, participants will be offered support, choice and flexibility regarding their preferred mode and type of exercise. This could include the option to receive an individualised home-based exercise program, and/or referral to existing formal structured exercise rehabilitation services available at Eastern Health, with timing based on patient readiness. These patient-centered exercise consultations are intended to: - provide individualised, evidence-based information about the role of physical activity and exercise in cancer recovery and survivorship, - support participants to initiate or maintain physical activity across different stages of treatment; and, - address common barriers to exercise, build confidence and promote sustainable exercise behaviour. Structure and Timing of the Intervention The physiotherapist will conduct three one-on-one exercise consultation sessions with each participant in the intervention group. The initial session is expected to last up to one hour and subsequent sessions are expected to last up to 30 minutes. After randomisation, participants in the intervention group will be scheduled to attend these sessions: before, 2 weeks after surgery and 8 weeks following discharge from surgery. These sessions will be scheduled to align with key milestones in the participant’s cancer care pathway. Mode of Delivery of Intervention The first exercise consultation will ideally be conducted in person or via videoconference, according to patient preference. Subsequent sessions will be delivered in person or via telehealth (videoconference or telephone), based on participant preference, clinical need and feasibility. The initial session is expected to last up to one hour and subsequent sessions are expected to last up to 30 minutes. Additional brief follow-up contacts (e.g. check-in calls or emails) may occur if a participant has expressed a need to clarify any information about exercise. The mode of delivery may vary across the three consultations to support accessibility and continuity of care. Adherence to the intervention will be monitored using records of the number and duration of completed sessions with physiotherapist and records of content covered in sessions.
Sponsors
Eastern Health
Study design
Allocation
Randomised controlled trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Participants will be eligible if they are: - Aged 18 years and over - Diagnosed with stages I-III colorectal cancer - Within 6 weeks of planned primary tumour resection surgery for colorectal cancer at Eastern Health - Able to ambulate independently with or without a walking aid - Have an Australian Karnofsky Performance Status score of =50 (Requires considerable assistance and frequent medical care, but is able to care for most of their personal needs) - Able to communicate in conversational English - Able to give written informed consent as recorded in the medical record or as assessed by their treating clinician or trial assessor.
Exclusion criteria
Participants will be excluded if they: - Have a medical condition (e.g. severe immunocompromise; unstable angina, unstable hypertension, or unstable heart failure) that contraindicates exercise and deemed at potential risk of medical deterioration as determined by the research physiotherapist and/or medical team - Have a cognitive impairment as determined by their treating clinician - Are receiving end of life care - Are planned for surgery unrelated to primary tumour resection (e.g. stoma reversal)
Outcome results
None listed