Does pre-operative physical rehabilitation improve the functional outcomes of patients undergoing gastrointestinal cancer surgery?
Tsuyoshi Hara, Eisuke Kogure, Akira Kubo and 1 others
PMID 33814720WHAT IT FOUND
Patients who improved their walking distance before GI cancer surgery maintained it four weeks after, while those who deteriorated lost about 15% of it.
However, this pre-operative gain did not reduce post-operative complications or improve quality of life scores compared to those who did not improve.
Key findings
01Patients in the improvement group maintained their 6-minute walk distance at 4 weeks post-surgery (change ratio 100.2%), whereas the deterioration group lost approximately 15% of their baseline capacity (change ratio 84.1%).
02Changes in pre-operative exercise capacity did not significantly affect the rate of post-operative complications.
03All groups experienced significant declines in physical functioning, bodily pain, vitality, and emotional role scores four weeks after surgery compared to baseline.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was very small (33 patients) and conducted at a single center, limiting generalizability. It was an observational study, not a randomized controlled trial, so patients were not randomly assigned to exercise or control groups; all received the intervention. Exercise adherence was self-reported, introducing potential bias. Only the 6-minute walk test was used to assess exercise capacity; muscle strength, balance, and flexibility were not evaluated. 15 participants were lost to follow-up due to post-operative complications, which may have skewed the remaining sample.
Declared interests
The study was funded by a grant from the Japan Society for the Promotion of Science. The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that pre-operative exercise prevents post-operative complications. The study found no significant difference in complication rates between patients who improved their exercise capacity and those who did not. The benefit observed was limited to maintaining walking distance, not improving surgical outcomes.