Endurance training alone was found to increase both lower extremity strength and endurance capacity .
Colorectal cancer surgery results in considerable postoperative morbidity , mortality and reduced quality of life .
As many patients will undergo additional (neo)adjuvant therapy , it is imperative that each individual optimize their physical function .
To eluci date the potential of exercise in patient optimization , we investigated the evidence for an exercise program before and after surgical treatment in colorectal cancer patients .
Impact of preoperative change in physical function on postoperative recovery: argument supporting prehabilitation for colorectal surgery.
BACKGROUND Abdominal surgery represents a physiologic stress and is associated with a period of recovery during which functional capacity is often diminished . " Prehabilitation " is a program to increase functional capacity in anticipation of an upcoming stressor . We reported recently the results of a r and omized trial comparing 2 prehabilitation programs before colorectal surgery  ( stationary cycling plus weight training versus a recommendation to increase walking coupled with breathing exercises ) ; however , adherence to the programs was low . The objectives of this study were to estimate : ( 1 ) the extent to which physical function could be improved with either prehabilitation program and identify variables associated with response ; and ( 2 ) the impact of change in preoperative function on postoperative recovery . METHODS This study involved a re analysis of data arising from a r and omized trial . The primary outcome measure was functional walking capacity measured by the Six-Minute Walk Test ; secondary outcomes were anxiety , depression , health-related quality of life , and complications ( Clavien classification ) . Multiple linear regression was used to estimate the extent to which key variables predicted change in functional walking capacity over the prehabilitation and follow-up periods . RESULTS We included 95 people who completed the prehabilitation phase ( median , 38 days ; interquartile range , 22 - 60 ) , and 75 who were also evaluated postoperatively ( mean , 9 weeks ) . During prehabilitation , 33 % improved their physical function , 38 % stayed within 20 m of their baseline score , and 29 % deteriorated . Among those who improved , mental health , vitality , self-perceived health , and peak exercise capacity also increased significantly . Women were less likely to improve ; low baseline walking capacity , anxiety , and the belief that fitness aids recovery were associated with improvements during prehabilitation . In the postoperative phase , the patients who had improved during prehabilitation were also more likely to have recovered to their baseline walking capacity than those with no change or deterioration ( 77 % vs 59 % and 32 % ; P = .0007 ) . Patients who deteriorated were at greater risk of complications requiring reoperation and /or intensive care management . Significant predictors of poorer recovery included deterioration during prehabilitation , age > 75 years , high anxiety , complications requiring intervention , and timing of follow-up assessment . CONCLUSION In a group of patients undergoing scheduled colorectal surgery , meaningful changes in functional capacity can be achieved over several weeks of prehabilitation . Patients and those who care for them , especially those with poor physical capacity , should consider a prehabilitation regimen to enhance functional exercise capacity before colectomy
Endurance training alone was found to increase both lower extremity strength and endurance capacity .
Colorectal cancer surgery results in considerable postoperative morbidity , mortality and reduced quality of life .
As many patients will undergo additional (neo)adjuvant therapy , it is imperative that each individual optimize their physical function .
To eluci date the potential of exercise in patient optimization , we investigated the evidence for an exercise program before and after surgical treatment in colorectal cancer patients .