Emma R J Bruns1, Tanja E Argillander, Henk Jan Schuijt, Peter van Duijvendijk, Edwin S van der Zaag, Eelco B Wassenaar, Michael F Gerhards, Esther C Consten, Christianne J Buskens, Barbara C van Munster, Willem A Bemelman. 1. From the Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands (ERJB, CJB, WAB); Department of Surgery, Gelre Hospitals, Apeldoorn, The Netherlands (ERJB, TEA, HJS, PvD, ESvdZ, EBW); Department of Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands (TEA, BCvM); Department of Surgery, OLVG Hospitals, Amsterdam, The Netherlands (MFG); Department of Surgery, Meander Medical Center, Amersfoort, The Netherlands (ECC); and Department of Geriatric Medicine, Gelre Hospitals, Apeldoorn, The Netherlands (BCvM).
Abstract
OBJECTIVE: The preoperative phase is a potential window of opportunity. Although frail elderly patients are known to be more prone to postoperative complications, they are often not considered capable of accomplishing a full prehabilitation program. The aim of this study was to assess the feasibility of Fit4SurgeryTV, an at-home prehabilitation program specifically designed for frail older patients with colorectal cancer. DESIGN: The Fit4SurgeryTV program consisted of a daily elderly adapted computer-supported strength training workout and two protein-rich meals. Frail patients 70 yrs or older with colorectal cancer were included. The program was considered feasible if 80% of the patients would be able to complete 70% of the program. RESULTS: Fourteen patients (median age, 79 yrs; 5 males) participated. At baseline, 86% patients were physically impaired and 64% were at risk for malnourishment. The median duration of the program was 26 days. The program was feasible as patients followed the exercises for 6 (86%) of 7 days and prepared the recipes 5 (71%) of 7 d/wk. Patients specifically appreciated at-home exercises. CONCLUSIONS: This study showed that at-home prehabilitation in frail older patients with colorectal cancer is feasible. As a result, patients might be fitter for surgery and might recover faster. The perioperative period could serve as a pivotal time point in reverting complications of immobility.
OBJECTIVE: The preoperative phase is a potential window of opportunity. Although frail elderly patients are known to be more prone to postoperative complications, they are often not considered capable of accomplishing a full prehabilitation program. The aim of this study was to assess the feasibility of Fit4SurgeryTV, an at-home prehabilitation program specifically designed for frail older patients with colorectal cancer. DESIGN: The Fit4SurgeryTV program consisted of a daily elderly adapted computer-supported strength training workout and two protein-rich meals. Frail patients 70 yrs or older with colorectal cancer were included. The program was considered feasible if 80% of the patients would be able to complete 70% of the program. RESULTS: Fourteen patients (median age, 79 yrs; 5 males) participated. At baseline, 86% patients were physically impaired and 64% were at risk for malnourishment. The median duration of the program was 26 days. The program was feasible as patients followed the exercises for 6 (86%) of 7 days and prepared the recipes 5 (71%) of 7 d/wk. Patients specifically appreciated at-home exercises. CONCLUSIONS: This study showed that at-home prehabilitation in frail older patients with colorectal cancer is feasible. As a result, patients might be fitter for surgery and might recover faster. The perioperative period could serve as a pivotal time point in reverting complications of immobility.
Authors: Nicole M Saur; Isacco Montroni; Armin Shahrokni; Hiroko Kunitake; Fabio M Potenti; Robert C Goodacre; Bradley R Davis; Francesco Carli Journal: Dis Colon Rectum Date: 2020-11 Impact factor: 4.412