Colorectal Cancer
Conditions
Keywords
cancer, colorectal, exercise, physical fitness
Brief summary
This study examines whether a home-based telephone-guided preoperative exercise programme is feasible and effective in improving cardiorespiratory fitness in patients with colorectal cancer who are high risk due to their existing co-morbidity.
Detailed description
Preoperative exercise, also know as prehabilitation, has been shown to improve physical fitness and potentially reduce postoperative complications in patients undergoing surgery. Patients are often labelled high risk for surgery due to their existing ill-health e.g. heart and lung disease. High risk patients comprise approximately 12% of all elective cancer cases, but account for 80% of all post-operative mortality. Complications significantly affect the quality of life of each CRC patient, both in the short and long-term, and can also impact on survival. It is critical that patients who are deemed at high risk of complications are optimised in the preoperative period. Exercise in the period before surgery is therefore one potential method of improving high risk patients' physical fitness levels while potentially reducing their risk of postoperative complications and subsequent mortality.
Interventions
BEHAVIORALExercise intervention
Graduated walking programme, strengthening exercises and respiratory muscle training.
Sponsors
University of Southampton
NHS Lanarkshire
National Heatlh Service Ayrshire and Arran
NHS Greater Glasgow and Clyde
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Primary operable colorectal cancer; * Awaiting surgery with curative intent; * Deemed high risk by the responsible clinical team; * Ability to mobilise independently
Exclusion criteria
* Patients with primary or recurrent inoperable colorectal cancer. * Patients undergoing preoperative chemo- and/or radiotherapy. * Patients who decline or are deemed unfit for operative management. * Patients who lack capacity to consent.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in cardiorespiratory fitness | Preoperative period: 4 weeks | Anaerobic threshold as measured by CPET |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Length of stay in high dependency and intensive care | Postoperative period: up to 8 weeks | Critical Care bed days |
| Readmission to critical care | Postoperative period: up to 8 weeks (within index admission) | Critical Care bed days |
| Time to medical discharge | Postoperative period: up to 8 weeks. | Medically fit for discharge |
| Hospital length of stay | Postoperative period: within 30 days. | Days |
| Readmission rate | Within 30 days of discharge. | — |
| Post-operative morbidity | Post-operative period: at 30 days post-surgery (week 8). | Clavien-Dindo Scale |
| Health-related quality of life | Baseline (week 0), post-intervention (week 4), at 30 days postoperatively (week 8). | SF-36 |
| Psychological health | Baseline (week 0), post-intervention (week 4), at 30 days postoperatively (week 8). | Hospital Anxiety and Depression Score (HADS) |
| Frailty | Baseline (week 0) and repeat testing (week 4). | Clinical Frailty Score (CSHA) |
| Redox blood samples | Baseline (week 0) and repeat CPET (week 4). | Redox status in pre- and post-exercise blood samples |
| Survival | 3 years post-operatively. | Overall and cancer-specific |
Other
| Measure | Time frame | Description |
|---|---|---|
| Feasibility of home-based exercise | Preoperative period: 4 weeks. | Recruitment, retention, adherence rates |
Countries
United Kingdom
Contacts
Primary ContactKatrina A Knight
Outcome results
None listed