title: A systematic review of pre-surgical exercise intervention studies with cancer patients.
abstract: BACKGROUND
  Recent reviews suggest that enhancing fitness and functional capacity prior to surgery can accelerate post-surgery recovery and reduce mortality. However, the effect of pre-surgical exercise interventions in cancer patients is not fully explained. The aim of this paper is to systematically review the available literature regarding pre-surgery exercise training interventions in cancer patients and examine their effects on physiological outcomes as well as quality of life (QOL) and length of hospital stay.
  
  
  METHODS
  Relevant studies were identified through a search on MEDLINE, PreMEDLINE, AMED, MEDLINE Daily Update, CINAHL and SPORTDiscus. All randomized controlled trials (RCTs) and non-RCTs that had some form of physical exercise undertaken prior to surgery were included. Descriptive characteristics such as participant characteristics, study design, types of cancer, length of study, and primary outcomes were extracted. Methodological rigour was assessed using a modified Delphi List. Due to the heterogeneity and the dearth of pre-surgical studies, we were limited to a systematic review rather than a meta-analysis.
  
  
  RESULTS
  Eighteen studies were included consisting of a total of 966 participants. Lung cancer studies were the predominant group represented. Most of the studies prescribed an aerobic intervention programs done prior to surgery. Mode, frequency, duration, and intensity of exercise intervention varied across the different cancer groups. The majority of studies showed preliminary positive change in clinical outcomes with significant improvements in the rate of incontinence, functional walking capacity and cardiorespiratory fitness.
  
  
  CONCLUSIONS
  Pre-surgical exercise may benefit cancer patients through positive effects on function and physical capacity. Surgical oncologists may consider pre-surgical exercise interventions as a potential adjuvant therapy to improve patients' outcomes.
authors: Edith Cowan University Health and Wellness Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, Western Australia 6027, Australia. f.singh@ecu.edu.au
authors: Favil
authors: F
authors: Singh
authors: Robert U
authors: RU
authors: Newton
authors: Daniel A
authors: DA
authors: Galvão
authors: Nigel
authors: N
authors: Spry
authors: Michael K
authors: MK
authors: Baker
mesh_terms: D005081:Exercise Therapy; D006801:Humans; D009369:Neoplasms / Q000601:surgery / Q000628:therapy*; D011300:Preoperative Care; D011379:Prognosis