• Stefanus J van Rooijen, Charlotte J L Molenaar, Goof Schep, Rianne H M A van Lieshout, Sandra Beijer, Rosalie Dubbers, Nicky Rademakers, Nicole E Papen-Botterhuis, Suzanne van Kempen, Francesco Carli, Roumen Rudi M H RMH, and Gerrit D Slooter.
• From the Department of Surgical Oncology, Máxima MC, Veldhoven, The Netherlands (SJvR, CJLM, NEP-B, RMHR, GDS); Department of Sports Medicine, Máxima MC, Veldhoven, The Netherlands (GS); Department of Nutrition, Máxima MC, Veldhoven, The Netherlands (RHMAvL); Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands (SB); Department of Physiotherapy, Máxima MC, Veldhoven, The Netherlands (RD, NR); Department of Psychology, Máxima MC, Veldhoven, The Netherlands (SvK); and Department of Anesthesiology, the Montréal General Hospital, McGill University, Montréal, Quebec, Canada (FC).
• Am J Phys Med Rehabil. 2019 Oct 1; 98 (10): 888-896.

BackgroundConsidering the relation between preoperative functional capacity and postoperative complications, enhancing patients' functional capacity before surgery with a prehabilitation program may facilitate faster recovery and improve quality of life. However, time before surgery is short, mandating a multimodal and high-intensity training approach. This study investigated feasibility and safety of a prehabilitation program for colorectal cancer.MethodsMultimodal prehabilitation was offered to patients eligible for participation and they were assigned to an intervention or control group by program availability. The prehabilitation program consisted of the following four interventions: in-hospital high-intensity endurance and strength training, high-protein nutrition and supplements, smoking cessation, and psychological support. Program attendance, patient satisfaction, adverse events, and functional capacity were determined.ResultsFifty patients participated in this study (prehabilitation 20, control 30). Program evaluation revealed a high (90%) attendance rate and high level of patient satisfaction. No adverse events occurred. Endurance and/or strength were improved. Eighty-six percent of patients with prehabilitation recovered to their baseline functional capacity 4 weeks postoperatively, 40% in the control group (P < 0.01).ConclusionsMultimodal prehabilitation including high-intensity training for colorectal cancer patients is feasible, safe, and effective. A randomized controlled trial (NTR5947) was initiated to determine whether prehabilitation may lower morbidity and mortality rates in colorectal surgery.

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