title: Exercise-based pre-habilitation is feasible and effective in radical cystectomy pathways-secondary results from a randomized controlled trial.
abstract: Physical exercises offer a variety of health benefits to cancer survivors during and post-treatment. However, exercise-based pre-habilitation is not well reported in major uro-oncology surgery. The aim of this study was to investigate the feasibility, the adherence, and the efficacy of a short-term physical pre-habilitation program to patients with invasive bladder cancer awaiting radical cystectomy (RC).
  
  
  
  A parent prospective randomized controlled clinical trial investigated efficacy of a multidisciplinary rehabilitation program on length of stay following RC. A total of 107 patients were included in the intension-to-treat population revealing 50 patients in the intervention group and 57 patients in the standard group. Pre-operatively, the intervention group was instructed to a standardized exercise program consisting of both muscle strength exercises and endurance training. The number of training sessions and exercise repetitions was patient-reported. Feasibility was expressed as adherence to the program and efficacy as the differences in muscle power within and between treatment groups at time for surgery.
  
  
  
  A total of 66 % (95 % confidence interval (CI) 51; 78) adhered more than 75 % of the recommended progressive standardized exercise program. In the intervention group, a significant improvement in muscle power of 18 % (p < 0.002) was found at time for surgery. Moreover, muscle power was significantly improved compared to that in the standard group with 0.3 W/kg (95 % CI 0.08; 0.5 %) (p < 0.006). Adherence was not associated with pre-operative BMI, nutritional risk, comorbidity, pain, gender, or age.
  
  
  
  In patients awaiting RC, a short-term exercise-based pre-habilitation intervention is feasible and effective and should be considered in future survivorship strategies.
authors.affiliation: Department of Urology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark. benjense@rm.dk.|Department of Urology, Aarhus University Hospital, Aarhus, Denmark. benjense@rm.dk.
authors.forename: Bente Thoft
authors.initials: BT
authors.lastname: Jensen
authors.affiliation: Department of Urology, Aarhus University Hospital, Aarhus, Denmark.|Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Sussie
authors.initials: S
authors.lastname: Laustsen
authors.affiliation: Department of Urology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Jørgen Bjerggaard
authors.initials: JB
authors.lastname: Jensen
authors.affiliation: Department of Urology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Michael
authors.initials: M
authors.lastname: Borre
authors.affiliation: Department of Urology, Aarhus University Hospital, Aarhus, Denmark.|Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Annemette Krintel
authors.initials: AK
authors.lastname: Petersen
mesh_terms: D000368:Aged; D015653:Cystectomy / Q000534:rehabilitation*; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Adherence; Exercise-based intervention; Muscle power; Physical capacity; Pre-habilitation; Radical cystectomy; Recovery