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Eur J Surg Oncol. 2019 Sep;45(9):1592-1597. doi: 10.1016/j.ejso.2019.04.015. Epub 2019 Apr 25.

In-hospital resistance training to encourage early mobilization for enhanced recovery programs after colorectal cancer surgery: A feasibility study.

Author information

1
Department of Kinesiology and Physical Education, McGill University, Currie Gymnasium, 475 Pine Avenue West, Montreal, Quebec, H2W 1S4, Canada; Department of Anesthesia, McGill University, Montreal General Hospital, 1650 Cedar Avenue, D10-144, Montreal, Quebec, H3G 1A4, Canada.
2
Department of Anesthesia, McGill University, Montreal General Hospital, 1650 Cedar Avenue, D10-144, Montreal, Quebec, H3G 1A4, Canada.
3
Department of Kinesiology and Physical Education, McGill University, Currie Gymnasium, 475 Pine Avenue West, Montreal, Quebec, H2W 1S4, Canada; Department of Anesthesia, McGill University, Montreal General Hospital, 1650 Cedar Avenue, D10-144, Montreal, Quebec, H3G 1A4, Canada; McGill Research Centre for Physical Activity & Health, McGill University, Faculty of Education, 3700 McTavish, Montreal, Quebec, H3A 1Y2, Canada. Electronic address: celena.scheede@mcgill.ca.

Abstract

BACKGROUND:

The enhancement of post-operative care is under constant evolution and, with the addition of enhanced recovery programs, is changing the traditional in-hospital paradigm. Despite these advances, there is a clear lack of focus regarding early post-surgical mobilization, which has been identified as an important aspect of recovery. This pilot study investigates the feasibility of initiating resistance exercise to promote early mobilization in colorectal cancer patients during the in-hospital period.

METHOD:

Patients participated in a supervised progressive resistance exercise program, adapted to their physical ability (either in bed, seated or standing), within the first 24 h following surgery. They were seen each day during the hospital stay and encouraged to continue exercising upon discharge. All patients were asked to return to the lab at four weeks after surgery for re-evaluation to establish recovery.

RESULTS:

Patient compliance to the in-hospital program was high, with 90% of patients engaging in exercise on the first post-operative day (POD 1) and no adverse effects reported during study. By POD 2, over 70% of patients met enhanced recovery after surgery (ERAS) recommendations.

CONCLUSION:

It is feasible to initiate a progressive post-operative resistance exercise program in patients undergoing colorectal resection. The results suggest the positive aspects of incorporating resistance exercise into post-operative care. This may facilitate a clear and easy to implement exercise intervention that can take into consideration patient physical status and limited facility space in the hospital environment.

KEYWORDS:

Colorectal cancer surgery; Early mobilization; In-hospital exercise; Resistance exercise

PMID:
31053478
DOI:
10.1016/j.ejso.2019.04.015

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