Loughney, Lisa, West, Malcolm A, Moyses, Helen, Bates, Andrew, Kemp, Graham J, Hawkins, Lesley, Varkonyi-Sepp, Judit, Burke, Shaunna, Barben, Christopher P, Calverley, Peter M et al (show 5 more authors)
(2021)
The effects of neoadjuvant chemoradiotherapy and an in-hospital exercise training programme on physical fitness and quality of life in locally advanced rectal cancer patients: a randomised controlled trial (The EMPOWER Trial).
PERIOPERATIVE MEDICINE, 10 (1).
23-.
Abstract
<h4>Background</h4>The EMPOWER trial aimed to assess the effects of a 9-week exercise prehabilitation programme on physical fitness compared with a usual care control group. Secondary aims were to investigate the effect of (1) the exercise prehabilitation programme on psychological health; and (2) neoadjuvant chemoradiotherapy (NCRT) on physical fitness and psychological health.<h4>Methods</h4>Between October 2013 and December 2016, adults with locally advanced rectal cancer undergoing standardised NCRT and surgery were recruited to a multi-centre trial. Patients underwent cardiopulmonary exercise testing (CPET) and completed HRQoL questionnaires (EORTC-QLQ-C30 and EQ-5D-5L) pre-NCRT and post-NCRT (week 0/baseline). At week 0, patients were randomised to exercise prehabilitation or usual care (no intervention). CPET and HRQoL questionnaires were assessed at week 0, 3, 6 and 9, whilst semi-structured interviews were assessed at week 0 and week 9. Changes in oxygen uptake at anaerobic threshold (VO<sub>2</sub> at AT (ml kg<sup>-1</sup> min<sup>-1</sup>)) between groups were compared using linear mixed modelling.<h4>Results</h4>Thirty-eight patients were recruited, mean age 64 (10.4) years. Of the 38 patients, 33 were randomised: 16 to usual care and 17 to exercise prehabilitation (26 males and 7 females). Exercise prehabilitation significantly improved VO<sub>2</sub> at AT at week 9 compared to the usual care. The change from baseline to week 9, when adjusted for baseline, between the randomised groups was + 2.9 ml kg <sup>-1</sup> min <sup>-1</sup>; (95% CI 0.8 to 5.1), p = 0.011.<h4>Conclusion</h4>A 9-week exercise prehabilitation programme significantly improved fitness following NCRT. These findings have informed the WesFit trial (NCT03509428) which is investigating the effects of community-based multimodal prehabilitation before cancer surgery.<h4>Trial registration</h4>ClinicalTrials.gov NCT01914068 . Registered 1 August 2013.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Exercise prehabilitation, Neoadjuvant cancer treatment, Physical fitness, Rectal cancer, Surgery |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 20 Jan 2022 09:35 |
| Last Modified: | 18 Jan 2023 21:15 |
| DOI: | 10.1186/s13741-021-00190-8 |
| Open Access URL: | https://doi.org/10.1186/s13741-021-00190-8 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3147245 |
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