Please select the eligibility criteria that correspond to the clinical trial below.
Title: Enhancing Outcomes After Colon Surgery: Role of Prehabilitation Facilitating the Recovery Process.
Brief Summary: Most patients find that recovering from surgery is difficult particularly after abdominal surgery for cancer or other intestinal disorders. The surgical stress, healing process and concerns if further treatments are required suggest that the post-operative period may not be the best time to get people to exercise to rehabilitate lost functions. Prehabilitation is the process of enhancing functional capacity of the individual to enable him or her to withstand an incoming stressor, such as surgery, and this study aims to evaluate the effectiveness of prehabilitation for colorectal surgery. Two groups will be formed by a random process and the prehabilitation group will use an exercise cycle and weights to build endurance and strength for a 3-week period prior to surgery. The other group will receive training about exercises that will help them move better after surgery. People who are malnourished prior to surgery will receive nutritional supplements. The results of this trial will be used to inform practitioners and patients alike of the benefits (or risks if any) of exercise in preparing for surgery.


Options:
A: Inclusion Criteria:

* primary colorectal cancer
* operated in one of four participating certified cancer centres for colorectal cancer (Krankenhaus Barmherzige Brüder, Department of Surgery, Regensburg; Germany; Caritas-Krankenhaus St. Josef, Department of Surgery, Regensburg; Germany; Klinikum Neumarkt., Department of Surgery, Neumarkt; Germany; Klinikum St. Elisabeth Straubing, Department of Surgery, Straubing, Germany), documented in a population-based cancer registry (Tumor Center Regensburg e.V.)
* informed consent.

Exclusion Criteria:

* coordinating practitioner not implemented
* patient from district outside the study region (rural districts Regensburg, Neumarkt, Straubing, Straubing-Bogen, Kelheim, Schwandorf)
* patient unable to fill out the questionnaire for physical, psychological or language reasons (including dementia)
* age under 18 years
* pregnancy
* QoL clinician unavailable
* refusal to participate
B: Inclusion Criteria:

* All patients listed to undergo elective colorectal cancer resection and longcourse neoadjuvant chemoradiotherapy at Aintree University Hospitals NHS Foundation Trust

Exclusion Criteria:

* Unable to consent
* Under 18 years of age
* Unable to perform exercise
* Meet any contraindications on the ATS CPET safety guidelines
C: Inclusion Criteria:

* Age 18 and above
* Referred electively for colorectal resection for benign (polyposis adenoma diverticulitis) or non-disseminated colon and rectum cancers
* Referred electively for colorectal resection for colon reconstruction for non-active inflammatory bowel disease
* Referred electively for colorectal resection for fibrostenotic conditions that are a feature of Crohn's disease.

Exclusion Criteria:

* People with American Society of Anesthesiologists health status class 4-5
* Co-morbid medical conditions interfering with the ability to participate in either group or complete the testing procedures (e.g. dementia, disabling orthopedic and neuromuscular disease, psychosis)
* Patients at high risk for a cardiac complication during exercise at home: severe aortic stenosis, cardiac failure Class IV NYHA, myocardial infarction within 6 months, congestive heart failure, and unstable angina
* Persons with sepsis; and treatment with chemotherapy or radiotherapy during six months prior to the date of surgery
* Those with very low exercise tolerance (\<3.5 METS) as determined by the baseline exercise test
* Anyone with a cardiac arrhythmia that manifests during the baseline exercise testing, prior to randomization
* Those people who are already in excellent physical condition owing to a regular participation in a high intensity physical activity. On testing, persons whose age-predicted value on the 6MWT exceeds 130% will be excluded (expected \<10%)
D: Inclusion Criteria:

* referred for scheduled surgery for nonmetastasized colorectal cancer
* age \> 18 years old

Exclusion Criteria:

* asa 4-5
* Poor English or French comprehension
* severe co-morbid disease interfering with ability to perform exercise at home or complete testing

Answer: C