Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Dec 12;33(1):20.
doi: 10.1007/s00520-024-09069-y.

Effect of home-based exercise prehabilitation on postoperative outcomes in colorectal cancer surgery: a systematic review and meta-analysis

Pedro Machado  1   2   3 , André Paixão  4 , Bárbara Oliveiros  5   6   7 , Raul A Martins  8 , Joana Cruz  9
Affiliations
Meta-Analysis

Effect of home-based exercise prehabilitation on postoperative outcomes in colorectal cancer surgery: a systematic review and meta-analysis

Pedro Machado et al. Support Care Cancer. .

Abstract

Purpose: Home-based exercise training may improve access to surgical prehabilitation in colorectal cancer (CRC) patients, but its efficacy remains unclear. This study systematically investigated the effects of home-based exercise prehabilitation on postoperative exercise capacity, complications, length of hospital stay, and health-related quality of life (HRQoL) in CRC patients.

Methods: Randomized controlled trials (RCTs) comparing home-based exercise prehabilitation with control in CRC patients were eligible. We searched MEDLINE, Scopus, Web of Science, PEDro, and SPORTDiscus from their inception to June 3, 2024. Methodological quality was assessed using the PEDro scale, and certainty of evidence was assessed using GRADE. Data were synthesized using random-effects meta-analyses, with sensitivity analysis on studies with good methodological quality (PEDro score ≥ 6).

Results: Eight RCTs involving 1092 participants were included. The primary analysis showed a significant improvement in postoperative 6-min walk distance following home-based exercise prehabilitation compared to control (mean difference (MD) = 30.62: 95% CI: [2.94; 57.79]; low-certainty evidence). However, sensitivity analysis revealed no significant between-group differences (MD = 22.60: 95% CI: [- 6.27; 51.46]). No significant effects of home-based exercise prehabilitation were found on postoperative complications (risk ratio = 1.00: 95% CI: [- 0.78; 1.29]; moderate-certainty evidence), length of hospital stay (MD = - 0.20: 95% CI: [- 0.65; 0.23]; moderate-certainty evidence), and HRQoL (physical functioning: MD = 2.62: 95% CI: [- 6.16; 11.39]; mental functioning: MD = 1.35: 95% CI: [- 6.95; 9.65]; low and very-low certainty evidence).

Conclusion: Home-based exercise prehabilitation does not reduce postoperative complications and length of hospital stay after CRC surgery. Its effects on postoperative exercise capacity and HRQoL remain uncertain due to low-quality evidence.

Keywords: Colorectal cancer; Exercise training; Perioperative medicine; Prehabilitation; Surgical oncology.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing Interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart. RCT, randomized controlled trial
Fig. 2
Fig. 2
a Meta-analysis for the effect estimate on 6-min walk distance. b Sensitivity analysis for the effect estimate on 6-min walk distance, including only studies with a PEDro score ≥ 6. CI, confidence interval
Fig. 3
Fig. 3
a Meta-analysis for the effect estimate on postoperative complications. b Meta-analysis for the effect estimate on length of hospital stay. c Meta-analysis for the effect estimate on physical functioning. d Meta-analysis for the effect estimate on mental functioning. CI, confidence interval
See this image and copyright information in PMC

References

    1. American College of Sports Medicine (2014) ACSM’s resource manual for guidelines for exercise testing and prescription, 7th edn. Lippincott Williams & Wilkins, Philadelphia
    1. Andersson J, Angenete E, Gellerstedt M, Angerås U, Jess P, Rosenberg J, Fürst A, Bonjer J, Haglind E (2016) Health-related quality of life after laparoscopic and open surgery for rectal cancer in a randomized trial. Br J Surg 103:1746 - PMC - PubMed
    1. Antonescu I, Scott S, Tran TT, Mayo NE, Feldman LS (2014) Measuring postoperative recovery: what are clinically meaningful differences? Surgery 156:319–327 - PubMed
    1. Armijo-Olivo S, Saltaji H, Da Costa BR et al (2015) What is the influence of randomization sequence generation and allocation concealment on treatment effects of physical therapy trials? A meta-epidemiological study. BMJ Open 5:e008562–e008562 - PMC - PubMed
    1. Atoui S, Carli F, Bernard P, Lee L, Stein B, Charlebois P, Liberman AS (2024) Does a multimodal prehabilitation program improve sleep quality and duration in patients undergoing colorectal resection for cancer? Pilot randomized control trial. J Behav Med 47:43–61 - PubMed

MeSH terms

LinkOut - more resources