• Aron Onerup, John Andersson, Eva Angenete, David Bock, Mats Börjesson, Carolina Ehrencrona, Fagevik OlsénMonikaMDepartment of Health and Rehabilitation/Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Acade, Per-Anders Larsson, Hanna de la Croix, Anette Wedin, and Eva Haglind.
• Scandinavian Surgical Outcomes Research Group (SSORG), Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
• Ann. Surg. 2022 Mar 1; 275 (3): 448455448-455.

ObjectiveTo determine the effect of a short-term, unsupervised exercise intervention before and after colorectal cancer surgery on self-assessed physical recovery.Summary Of Background DataPreoperative exercise interventions could help improve recovery after colorectal cancer surgery and is currently recommended.MethodsA randomized, parallel, open-label trial in six university or regional hospitals in Sweden. Inclusion criteria were age ≥20 years and planned elective colorectal cancer surgery. Participants were randomized to either a physical activity intervention with aerobic activity and inspiratory muscle training 2 weeks pre- and 4 weeks postoperatively or usual care. The primary outcome measure was self-assessed physical recovery 4 weeks postoperatively. Analyses were performed according to intention to treat. Outcome assessors were masked regarding the intervention while both participants and physiotherapists were informed due to the nature of the intervention.ResultsBetween January 22, 2015, and May 28, 2020, 761 participants were recruited and assigned to either intervention (I) (n = 379) or control (C) (n = 382). After exclusions 668 participants (I = 317, C = 351) were included in the primary analysis. There was no effect from the intervention on the primary outcome measure (adjusted odds ratio 0.84, 95% confidence interval 0.62-1.15) with 13% and 15% of participants feeling fully physically recovered in I and C, respectively. There were no reported adverse events.ConclusionsThere was no effect from a physical activity intervention before and after colorectal cancer surgery on short-term self-assessed physical recovery. The results from this study call for reconsiderations regarding current recommendations for preoperative physical activity interventions.Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.

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