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Related Concept Videos

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Rationales for Prehabilitation Programs in Patients Preparing for Oncologic Surgery: A Systematic Review.

Emine Akdemir1,2, Wim G Groen3,4,5, Maike G Sweegers1,2

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Prehabilitation programs primarily focus on improving physical fitness before cancer surgery. However, specific exercise details and rationales often lack clarity, suggesting a need for more standardized and mechanistically grounded approaches to enhance effectiveness.

Keywords:
Oncological surgeryPhysical exercisePrehabilitationRationalesSystematic review

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Area of Science:

  • Oncology
  • Rehabilitation Medicine
  • Evidence-Based Practice

Background:

  • Prehabilitation aims to enhance patient resilience and recovery following surgery.
  • Understanding the rationale behind prehabilitation content can optimize program design.
  • This systematic review examines rationales, interventions, and outcomes in oncological prehabilitation studies.

Purpose of the Study:

  • To systematically review the rationales, intervention components, and outcomes of prehabilitation studies in oncological populations.
  • To identify opportunities for optimizing prehabilitation programs based on current practices and reported rationales.

Main Methods:

  • Systematic search of MEDLINE, Embase, and Scopus databases.
  • Inclusion of comparative prehabilitation studies in oncological surgery patients.
  • Extraction of reported rationales, program content (exercise type, frequency, intensity, duration), and primary endpoints.

Main Results:

  • 140 studies (24,925 patients) were included.
  • Improving physical fitness (cardiorespiratory) was the most common rationale (89%).
  • Psychological (33%) and metabolic (20%) rationales were less frequent. Exercise was predominantly supervised (41%), often 3x/week, including anaerobic components. Program duration varied (1-12 weeks). Surgical outcomes were the most reported endpoints (42%).

Conclusions:

  • Physical fitness is a primary rationale, but specific component rationales are often implicit.
  • Prehabilitation content and duration vary widely, influenced by feasibility and time constraints.
  • Standardized outcomes and mechanistically grounded approaches are recommended to improve prehabilitation design and effectiveness.