Pragmatic Prehabilitation for Colorectal Surgery
Condition: Prehabilitation; Colorectal Surgery; Enhanced Recovery After Surgery
Study type: Interventional

Summary: 
      Colorectal surgery is a common surgery for the treatment of colon and rectal cancers as well
      as other bowel diseases. Recovery from colorectal surgery is difficult because of the many
      potential negative side effects. These side effects include surgical complications,
      infections, and long hospital stays. It usually takes several months for patients to recover
      the strength required to return to their typical daily activities.

      The Enhanced Recovery After Surgery program was established in Alberta in 2013 and uses
      several strategies to improve short-term patient recovery, including earlier discharge from
      hospital. Whether the ERAS program also improves long-term patient recovery, including
      quality of life and return to activities of daily living, is unclear. Whether the ERAS
      program would benefit from the addition of a prehabilitation element is unclear.

      Prehabilitation programs are designed to use the waiting period before colorectal surgery to
      better prepare patients emotionally and physically for their operation. To date, successful
      prehabilitation programs have used a personalized care strategy where each patient is
      provided specific care instructions by healthcare professionals to meet their unique
      exercise, nutrition, and psychological needs. This prehabilitation strategy has been
      criticized for not being sustainable in our healthcare system.

      A new prehabilitation program in response to this criticism is proposed. The prehabilitation
      program will be conducted in a more sustainable way by offering the program as a group class
      with a home-based component. ERAS patients at the Peter Lougheed Center are already offered a
      group class as part of the standard ERAS program. The prehabilitation class will be an
      extension of this group class that provides general nutrition, exercise, and
      anxiety-reduction/relaxation strategies to help patients prepare physically and emotionally
      for their operation. At this class, patients will learn to eat well, practice deep breathing
      exercises for relaxation, perform simple functional exercises, and to walk for exercise
      before their surgery. The surgical experience and outcomes of patients who received the
      additional prehabilitation care will be compared to those who received ERAS care only.

      The overall goal of the study is to better understand how ERAS supports recovery after
      surgery and whether a prehabilitation program offers any additional benefits to the ERAS
      program currently in place.
    


Intervention name(s): Prehab; ERAS; Fitbit
Intervention type(s): Combination Product; Other; Behavioral
Intervention description(s): Exercise: functional exercises, walking, Fitbit goals Nutrition: handout, supplements (protein, vitamins, minerals) Stress reduction: deep breathing; Enhanced Recovery After Surgery guidelines are applied.; Fitbit is worn to monitor step counts.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Pragmatic RCT Effectiveness- Implementation Hybrid
Masking: None (Open Label)
Primary purpose: Treatment