Perspectives on the Direction of Cancer Prehabilitation in the Pandemic and Beyond.
San San Tay
PMID 36277731WHAT IT FOUND
A home-based cancer prehabilitation program using phone calls and a digital diary improved walking distance, leg strength, and anxiety in 188 patients.
It remained feasible during lockdowns, but without a control group, it is unclear if the program itself caused these gains.
Key findings
01Patients in the home-based program showed statistically significant improvements in the 6-minute walk test, 30-second sit-to-stand test, and timed up and go test before surgery.
02The program achieved an 86% recruitment rate and a 73% retention rate, demonstrating feasibility during pandemic restrictions.
03Adherence to the prescribed exercises was 65.9%, measured by completion of minimum sets and correct demonstration at follow-up.
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 lacked a control group, so it is impossible to determine if the observed improvements were due to the prehabilitation program or natural variation/regression to the mean. The intervention was multimodal, involving exercise, nutritional advice, medical optimization, and mental wellness support. The contribution of any single component cannot be separated. Adherence was moderate (65.9%), indicating that nearly one-third of patients did not fully comply with the prescribed exercises. The results are from a single center in Singapore, and cultural factors (e.g., willingness to exercise when encouraged by a physician) may limit generalizability to other settings. The average duration of prehabilitation was short (19.3 days), which may not be sufficient for all patient populations or cancer types.
The easy way to misread this
Do not assume the program caused the improvements. Without a control group, the gains in walking distance and anxiety scores could be due to factors other than the intervention. Additionally, the program included nutrition, medical, and psychological support alongside exercise, so the specific effect of the exercise prescription alone cannot be isolated.