Prehabilitation for Frail Patients Undergoing Colorectal Surgery: Lessons Learnt From a Randomised Feasibility Study.
Claire Furyk, Siva Senthuran, Dia Nye and 2 others
PMID 36188831WHAT IT FOUND
Only five of 106 screened frail patients were randomised, and just one completed all follow-up assessments.
Recruitment was blocked by short surgical waits, transport issues, and patients recoiling at the mention of exercise.
Key findings
01Recruitment was extremely poor, with only five patients out of a potential 106 being randomised into the study.
02Follow-up was high loss, as only one participant out of five managed to complete all the assessments to follow-up.
03A major barrier was that frail patients often refused participation because they were exhausted and had been advised by family and doctors to rest.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was a feasibility trial, not an efficacy trial, so it cannot determine if prehabilitation works. The sample size was tiny (n=5), meaning no statistical analysis of outcomes was possible. Recruitment barriers included the use of the Edmonton Frail Scale, which may have excluded patients who appeared frail to clinicians but did not meet the score cut-off. The short timeframe between diagnosis and surgery in the regional public health system made the 4-week intervention impossible for many patients.
Declared interests
The authors declared no commercial or financial conflicts of interest. The study was funded by the Townsville Hospital and Health Service Research Trust Fund and the Australian and New Zealand College of Anaesthetists Novice Investigator grant. The funders had no role in study design, data collection, analysis, or manuscript preparation.
The easy way to misread this
Do not interpret the lack of recruitment as evidence that prehabilitation is ineffective or unsafe. The study showed that frail patients can complete assessments and exercise without adverse reactions, but logistical and health barriers prevented a full trial from being run.