Feasibility and safety of an exercise-based prehabilitation intervention before cancer surgery: a pilot randomised controlled trial.
Declan T Hennessy, Anna Wong Shee, Jonathan C Rawstorn et al.
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In 30 seconds
This single-centre pilot randomised controlled trial assessed the feasibility and safety of supervised aerobic prehabilitation before surgery in patients with breast, colorectal, or prostate cancer. Of 47 potentially eligible patients approached, 23 were recruited and randomised to prehabilitation or usual care; 20 completed follow-up assessments. Among those who commenced prehabilitation, attendance was 91.3% and adherence was 82.6%. Five adverse events were recorded, all grade 1, and no significant group-by-time interactions were found for cardiorespiratory fitness, quality of life, or fatigue. The small, heterogeneous sample and recruitment limitations prevented firm conclusions about feasibility or effectiveness.
Key findings
- Among participants who commenced prehabilitation, attendance was 91.3%, adherence 82.6%, and completeness 85.7%.
- Five adverse events occurred in the prehabilitation group—fatigue (n = 3) and muscular pain in the extremities (n = 2)—all grade 1.
- No significant group-by-time interactions were observed for cardiorespiratory fitness, health-related quality of life, or fatigue.
- Of 47 potentially eligible patients approached and screened, 23 were recruited and randomised; 20 completed pre- and post-surgery assessments.
Why it matters
Exercise-based prehabilitation may be deliverable before cancer surgery for some participants, with high attendance and adherence among those who started and no serious adverse events observed. However, these feasibility findings do not establish clinical benefit. The results highlight the need to address recruitment and evaluate outcomes in a larger, less heterogeneous study before drawing conclusions about effectiveness.
What to keep in mind
The single-centre trial recruited only 23 patients, with a small heterogeneous sample and recruitment limitations. Exploratory clinical outcome estimates were imprecise, precluding firm conclusions about effectiveness or broader feasibility.