The Feasibility of Prehabilitation as Part of the Breast Cancer Treatment Pathway.
Fiona Wu, Roberto Laza-Cagigas, Aalia Pagarkar and 3 others
PMID 33369236WHAT IT FOUND
Patients wanted prehabilitation but short surgery waits meant only 24 of 61 interested patients could attend.
Anxiety scores improved in those who did. Other outcomes showed no significant change. The study proves delivery is possible but not that the program improves function.
Key findings
0181.3% of patients wanted to participate, but only 32% of those interested could actually attend and return results due to short wait times and logistics.
02Anxiety scores improved significantly after surgery in both groups who participated in prehabilitation, but no other patient-reported outcomes or healthcare resource measures showed significant differences.
03The intervention was multimodal, consisting of supervised exercise, nutritional advice, smoking cessation, and psychosocial support, making it impossible to attribute any specific result to exercise alone.
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 small pilot with only 44 patients, limiting the ability to detect differences between groups. Patients self-selected into the intervention or control group, introducing potential bias. The intervention was multimodal, so it is not possible to determine which component (exercise, nutrition, etc.) caused any observed changes. The duration of the program varied significantly based on surgical scheduling, with a median of only two weeks. Adherence to nutritional and psychosocial recommendations was self-reported and not objectively verified. No functional physical assessments were conducted due to the short timeframe.
Declared interests
The study was funded by an Independent Cancer Taskforce Strategy grant of £100,000 to set up the prehabilitation unit. No other conflicts of interest are explicitly declared in the text provided.
The easy way to misread this
Do not interpret the significant improvement in anxiety scores as evidence that exercise reduces anxiety. The intervention included psychosocial support and counseling for those with raised scores, and the study cannot separate the effect of exercise from the other components of the multimodal program.