Development process of an evidence-based exercise program for post-operative colorectal cancer patients

Abstract

Purpose: Exercise is generally accepted to be beneficial for colorectal cancer patients; however, very few studies have investigated the effects of exercise on patient care and health outcomes during the immediate post-operative recovery period. Furthermore, very few studies have investigated the safety, feasibility, and efficacy of exercise on post-operative cancer patients. Although intervention programs should be based on solid evidence from clinical trials, the majority of previous studies have not presented the development process of the intervention programs. This paper describes a ten-step development process of an inpatient exercise program for colorectal cancer patients after colectomy.

Methods: The development process is composed of the following ten steps: systematic literature review, understanding patient characteristics via patient survey, first expert group discussion, development of the first draft exercise program, pretest, focus group interview, second expert group discussion, pilot study, randomized controlled trial, and the final exercise program development.

Results: The exercise program developed through the ten-step process was divided into three phases according to the patients' condition. For all three phases, patients performed the exercises two times a day, once under supervision. Any specific exercises that caused pain on a given day were excluded from the exercise program for that day. The exercise program reduced the length of hospital stay and time to flatus in colorectal cancer patients after surgery.

Conclusion: This study reports a safe and effective means to develop an evidence-based exercise program not only for colorectal cancer patients but also for other population groups.

Keywords: Colorectal cancer; Development process; Evidence-based exercise; Exercise medicine; Post-surgery care.