[Exercise-induced laryngeal obstruction†: diagnosis and management]. / Obstruction laryngée induite à l'effort: méthodes diagnostiques et prise en charge.

Exercise-induced laryngeal obstruction (EILO) is a condition characterized by temporary narrowing or closure of the larynx during physical activity, in particular during intense physical exertion. It generally affects teenagers and young adults and is often misdiagnosed as exercise-induced asthma. Symptoms include dyspnea, wheezing and a feeling of throat tightness during exercise. The aim of this article is to review this often underrecognized condition, its diagnosis and its management.

L'obstruction laryngée induite à l'effort (EILO) est une affection caractérisée par le rétrécissement ou la fermeture temporaire du larynx au cours d'une activité physique, en particulier lors d'un effort physique intense. Elle touche généralement les adolescents et les jeunes adultes et est souvent diagnostiquée à tort comme de l'asthme d'effort. Les symptômes comprennent une dyspnée, une respiration sifflante et une sensation d'oppression au niveau de la gorge pendant l'exercice. Cet article passe en revue cette pathologie souvent méconnue, son diagnostic et sa prise en charge.

[Exercise training with blood flow restriction : mechanisms and applications]. / Entraînement avec occlusion vasculaire: mécanismes et applications.

Traditional guidelines state that substantial muscle development requires training at least 70% of the one-repetition maximum (1RM) load. However, recent evidence has proven that low load training (20-40 % 1RM) combined with moderate blood flow restriction (BFR) can also lead to improvements in muscle mass and strength. While BFR has primarily been studied in clinical populations, emerging evidence demonstrates the effectiveness of BFR in sport. This article displays the mechanisms, methods, protocols, risks, and known effects of BFR.

Les directives traditionnelles stipulent qu'un développement musculaire nécessite un entraînement avec une charge minimale correspondant à 70 % du maximum d'une répétition (1RM). Cependant, des preuves récentes suggèrent que l'entraînement à faible charge (20-40 % de 1RM), combiné à une restriction modérée du flux sanguin (Blood Flow Restriction, BFR), peut également entraîner des améliorations de la masse et de la force musculaires. Alors que le BFR a d'abord été principalement étudié sur des populations cliniques, de nouveaux travaux rapportent son efficacité en milieu sportif. Cet article présente les mécanismes, les méthodes, les protocoles, les risques ainsi que les effets connus du BFR.

[Prevention and management of running-related injuries]. / Prévention et prise en charge de la blessure liée à la course à pied.

Running related injury is a complex, multifactorial phenomenon that remains difficult to explain. However, there are available tools for clinicians allowing prevention (primary or tertiary) and rehabilitation optimization, thus reducing the consequences of the injury and time before returning to participation. These tools rely mainly on training load monitoring and clinical evaluation of stride biomechanical analysis. Unfortunately, they currently remain poorly known by practitioners, while allowing the opportunity to address the challenge of managing the injured runner, including a faster return to run, but also the prevention of a potential recurrence. It requires targeted intervention and education of the patient on the factors leading to the injury.

La blessure liée à la course à pied est un phénomène complexe, multifactoriel dont l'explication reste difficile. Cependant, des outils à disposition des cliniciens permettent d'agir de manière préventive (primaire ou tertiaire) et d'optimiser la rééducation afin de réduire les conséquences de la blessure et le délai avant la reprise de l'activité. Ces outils portent principalement sur le suivi de la charge d'entraînement et l'utilisation clinique de l'analyse biomécanique de la foulée. Ils sont toutefois aujourd'hui mal connus par les praticiens alors que leur utilisation permet de répondre à l'enjeu de la prise en charge du coureur comprenant un retour le plus rapide possible à la pratique, mais également la prévention d'une potentielle récidive. Cela sous-tend un travail ciblé et une éducation du patient sur les facteurs entraînant la blessure.

[Sweat as an indicator of health]. / La sueur comme indicateur de la santé.

Sweat is a body fluid produced by the sweat glands and is mainly composed of water. Sweat has various functions, the two main ones being the evacuation of heat produced by the body, especially during exercise, and the maintenance of skin homeostasis. Its production is highly variable and depends on many individual and environmental factors. Various diseases or conditions affect its proper functioning. This article presents an overview of the characteristics, the main health issues, and the current and potential applications related to sweat.

La sueur est un fluide corporel produit par les glandes sudoripares et composé principalement d'eau. La transpiration remplit diverses fonctions, dont les principales sont l'évacuation de la chaleur produite par l'organisme, en particulier durant l'effort physique, et le maintien de l'homéostasie de la peau. Sa production est très variable quantitativement et qualitativement et dépend de multiples facteurs individuels et environnementaux. Différentes pathologies ou conditions altèrent son bon fonctionnement. Cet article présente un aperçu des caractéristiques, des principaux problèmes de santé et des applications actuelles et potentielles en lien avec la sueur.

[Cryotherapy chambers and cold-water immersion : therapeutic use and risks]. / Chambres de cryothérapie et immersion en eau froide†: utilisation thérapeutique et risques.

Whole body cryotherapy is mainly performed either by immersion in cold water or in a cryotherapy chamber. Practiced since Antiquity and considered as a «â€…natural ¼ method, cryotherapy is attracting more and more followers. Beneficial health effects have been described in the literature. However, interpretation of its effects is difficult due to low quality of current studies. Cryotherapy could however be useful in addition to conventional therapies in various pathologies and situations, provided that the risks, contraindications and rules of good practice are known.

La cryothérapie du corps entier se pratique principalement soit par immersion en eau froide, soit en chambre de cryothérapie. Pratiquée depuis l'Antiquité et considérée comme une méthode «â€…naturelle ¼, la cryothérapie tend à attirer de plus en plus d'adeptes. Des effets bénéfiques pour la santé ont été décrits dans la littérature. Néanmoins, l'interprétation de ses effets est difficile en raison de la faible qualité des études actuelles. La cryothérapie pourrait toutefois être utile en complément des thérapies classiques dans diverses pathologies et situations, à condition de connaître les risques, les contre-indications et les règles de bonnes pratiques.

[Heart rate variability: methods, limitations and clinical examples]. / Analyse de la variabilité de la fréquence cardiaque†: méthodes, limites et exemples cliniques.

Heart rate variability (HRV) is an analysis of milliseconds variations in intervals between heartbeats and has become an increasingly used tool for clinical investigation of fatigue, especially in athletes. Eliciting an indirect index of the autonomic nervous system regulation on the heart rate, HRV correlates with different fatigue states and appears to be a powerful biomarker in their monitoring. This article presents the tools to familiarize with this method while detailing good practices for use and interpretation. A method allowing characterization of different fatigue states is also presented for a clinical use with a systemic approach.

L'analyse de la variabilité de la fréquence cardiaque (VFC) s'intéresse à l'observation des variations en millisecondes des intervalles entre les battements cardiaques et devient un outil d'investigation clinique de la fatigue de plus en plus utilisé, notamment chez les athlètes. Les paramètres étudiés reflètent indirectement la régulation de la fréquence cardiaque par le système nerveux autonome et la VFC est corrélée à différents états de fatigue, se révélant être un puissant biomarqueur dans le suivi de ces derniers. Cet article vise à donner les bases permettant de cerner la thématique et précise les bonnes pratiques quant à son utilisation et son interprétation. Une méthode permettant de caractériser différents états de fatigue est également présentée et donne des pistes pour une utilisation en clinique avec une approche systémique.

[Hamstring injury prevention]. / Prévention des lésions musculaires des ischio-jambiers.

Hamstring muscle injury is the first diagnosis of injury in sports involving sprints. Its prevention represents a fundamental challenge for the technical and health professionals around the athletes. Risk factors have been described and can be used for screening at-risk individuals (age, history of hamstring injury, strength deficit). Although every determinant of the occurrence of these injuries has not yet been determined, and currently available preventive measures are not fully effective (eccentric muscle strengthening and strength deficit screening), these preventive measures do exist and must be implemented to the benefit of athletes before more comprehensive approaches are developed and demonstrate greater efficiency.

La lésion musculaire des ischio-jambiers est le premier diagnostic de blessure dans les sports impliquant le sprint. Sa prévention représente un enjeu fondamental pour les professionnels techniques et de santé autour des sportifs. Des facteurs de risque ont été décrits et peuvent être utilisés dans le cadre d'un dépistage de sujet à risque (âge, antécédent(s) de lésion des ischio­jambiers, déficit de force). Bien que tous les déterminants de la survenue de ces blessures n'aient pas encore été appréhendés et que les mesures de prévention actuellement disponibles (renforcement musculaire excentrique et dépistage du déficit de force) ne soient pas d'une efficacité totale, ces dernières existent et doivent être mises au profit des sportifs avant que des approches plus globales ne soient développées et fassent preuve d'une meilleure efficacité.

[« My joints are cracking, is it serious doctor ? ¼ A review about sounds produced by joints]. / « Mes articulations craquent, c'est grave docteur ? ¼ Les bruits articulaires en question.

The sounds produced by joints are a common source of questioning for doctors and their patients. Two major types are identified : cracks and crepitus. Few investigations have been carried out on these manifestations, while they potentially have clinical implications, especially for patellar crepitus in patellofemoral osteoarthrosis, and may generate anxiety. Knuckle cracking appears to be caused by the sudden and temporary occurrence of an intra-articular gaseous cavity, called tribonucleation. Other researches on these sounds are focused on the knees and their links with osteoarthritis, as well as on the spine. Many questions still arise but it seems important to talk about it with patients without trivializing them.

Les bruits produits par les articulations sont une source de questionnements pour les médecins et leurs patients. Deux principaux types sont identifiés, les craquements et les grincements. Peu d'investigations ont été réalisées sur ces manifestations fréquentes alors qu'elles présentent potentiellement une implication clinique, notamment pour les grincements patellaires dans l'arthrose fémoro-patellaire, et qu'elles peuvent générer de l'anxiété. Les craquements des doigts semblent être provoqués par l'apparition soudaine et temporaire d'une cavité gazeuse intra-articulaire, appelée tribonucléation. Les autres recherches sur ces bruits se portent principalement sur les genoux et leurs liens avec l'arthrose, ainsi que sur le rachis. De nombreuses questions subsistent, mais il est nécessaire d'en parler avec les patients sans les banaliser.

[What do we know about the exercise-related transient abdominal pain ?] / Que sait-on sur le « point de côté ¼ lié à l'effort ?

Exercise-related transient abdominal pain or « side stitch ¼ is a very common problem among athletes, whatever their level of participation. This pain may be present in different areas of the abdomen, even in the shoulder, usually well localized, and described as cramping or stabbing depending on the severity. The etiology is still debated, with many possible theories. It is a benign problem but other pathologies, often more severe, must be excluded in case of any atypical presentation. There are simple preventive measures recommended. This pain usually disappears within minutes by slowing or stopping the effort and / or using different methods without scientific validation until now.

La douleur abdominale transitoire liée à l'effort ou « point de côté ¼ est un problème fréquemment rencontré chez les sportifs, qu'ils soient débutants ou confirmés. Cette douleur peut être présente dans différentes zones de l'abdomen, voire même les épaules, le plus souvent bien localisée, décrite comme une crampe ou « coup de couteau ¼ selon la sévérité. L'étiologie est encore débattue, avec de multiples théories possibles. Il s'agit d'un problème bénin mais d'autres pathologies, souvent plus graves, doivent être exclues devant toute présentation atypique. Il existe des mesures préventives simples à conseiller. Cette douleur disparaît généralement en quelques minutes en ralentissant ou stoppant l'effort et / ou à l'aide de différentes méthodes, sans validation scientifique à ce jour.

Short-duration aerobic high-intensity intervals versus moderate exercise training intensity in patients with peripheral artery disease: study protocol for a randomised controlled trial (the Angiof-HIIT Study).

INTRODUCTION: Supervised exercise training is among the first-line therapies for patients with peripheral artery disease (PAD). Current recommendations for exercise include guidance focusing on claudication pain, programme and session duration, and frequency. However, no guidance is offered regarding exercise training intensity. This study aims to compare the effects of 12-week-long supervised walking exercise training (high-intensity interval training (HIIT) vs moderate-intensity exercise (MOD)) in patients with chronic symptomatic PAD. METHODS AND ANALYSIS: This study is a monocentric, interventional, non-blinded randomised controlled trial. 60 patients (30 in each group) will be randomly allocated (by using the random permuted blocks) to 12 weeks (three times a week) of HIIT or MOD. For HIIT, exercise sessions will consist of alternating brief high-intensity (≥85% of the peak heart rate (HRpeak)) periods (≤60 s) of work with periods of passive rest. Patients will be asked to complete 1 and then 2 sets of 5-7 (progressing to 10-15×60 s) walking intervals. For the MOD group, exercise training sessions will consist of an alternation of periods of work performed at moderate intensity (≤76% HRpeak) and periods of passive rest. Interventions will be matched by training load. The primary outcome will be the maximal walking distance. Secondary outcomes will include functional performance, functional capacity, heath-related quality of life, self-perceived walking abilities, physical activity and haemodynamic parameters. ETHICS AND DISSEMINATION: The Angiof-HIIT Study was approved by the Human Research Ethics Committee of the Canton de Vaud (study number: 2022-01752). Written consent is mandatory prior to enrolment and randomisation. The results will be disseminated via national and international scientific meetings, scientific peer-reviewed journals and social media. TRIAL REGISTRATION NUMBER: NCT05612945.

Short-term effects on heart rate variability of occipito-mastoid suture normalization in healthy subjects.

Occipito-mastoid structure normalization (OMSN) is an osteopathic manipulative treatment aimed at reducing tension around the jugular foramen, where cranial nerves IX, X, and XI exit the skull. The purpose of this study was to observe how heart rate variability (HRV), a marker of autonomic cardiac regulation, was modulated after an OMSN vs. a sham technique (SHAM). Pre- and post-intervention HRV was analyzed in two randomly chosen groups of 15 participants (OMSN vs. SHAM group). HRV was collected in the supine position 5 min before and 5 min after a 10-min application of either OMSN or SHAM. The time and group effect was analyzed using a two-way ANOVA. Independently from group intervention, a significant time effect induced increased HRV. No group effect differences were observed. Multiple comparisons for time and group interaction showed that the root mean square of successive differences (RMSSD), a vagally mediated HRV variable, increased to a greater extent for the OMSN group (p = 0.03) than for the SHAM group. However, both OMSN and SHAM techniques had a significant effect on HRV. Compared to a SHAM technique, OMSN had a significant effect on HRV vagally related metric RMSSD in the short term. We conclude that 10 min of OMSN may be used to induce a short-term influence on parasympathetic autonomic nervous system modulations.

Consumer Wearable Health and Fitness Technology in Cardiovascular Medicine: JACC State-of-the-Art Review.

The use of consumer wearable devices (CWDs) to track health and fitness has rapidly expanded over recent years because of advances in technology. The general population now has the capability to continuously track vital signs, exercise output, and advanced health metrics. Although understanding of basic health metrics may be intuitive (eg, peak heart rate), more complex metrics are derived from proprietary algorithms, differ among device manufacturers, and may not historically be common in clinical practice (eg, peak V˙O2, exercise recovery scores). With the massive expansion of data collected at an individual patient level, careful interpretation is imperative. In this review, we critically analyze common health metrics provided by CWDs, describe common pitfalls in CWD interpretation, provide recommendations for the interpretation of abnormal results, present the utility of CWDs in exercise prescription, examine health disparities and inequities in CWD use and development, and present future directions for research and development.

Multisensing Wearables for Real-Time Monitoring of Sweat Electrolyte Biomarkers During Exercise and Analysis on Their Correlation With Core Body Temperature.

Sweat secreted by the human eccrine sweat glands can provide valuable biomarker information during exercise. Real-time non-invasive biomarker recordings are therefore useful for evaluating the physiological conditions of an athlete such as their hydration status during endurance exercise. This work describes a wearable sweat biomonitoring patch incorporating printed electrochemical sensors into a plastic microfluidic sweat collector and data analysis that shows the real-time recorded sweat biomarkers can be used to predict a physiological biomarker. The system was placed on subjects carrying out an hour-long exercise session and results were compared to a wearable system using potentiometric robust silicon-based sensors and to commercially available HORIBA-LAQUAtwin devices. Both prototypes were applied to the real-time monitoring of sweat during cycling sessions and showed stable readings for around an hour. Analysis of the sweat biomarkers collected from the printed patch prototype shows that their real-time measurements correlate well (correlation coefficient ≥ 0.65) with other physiological biomarkers such as heart rate and regional sweat rate collected in the same session. We show for the first time, that the real-time sweat sodium and potassium concentration biomarker measurements from the printed sensors can be used to predict the core body temperature with root mean square error (RMSE) of 0.02 °C which is 71% lower compared to the use of only the physiological biomarkers. These results show that these wearable patch technologies are promising for real-time portable sweat monitoring analytical platforms, especially for athletes performing endurance exercise.

Augmented Cooper test: Biomechanical contributions to endurance performance.

Running mechanics are modifiable with training and adopting an economical running technique can improve running economy and hence performance. While field measurement of running economy is cumbersome, running mechanics can be assessed accurately and conveniently using wearable inertial measurement units (IMUs). In this work, we extended this wearables-based approach to the Cooper test, by assessing the relative contribution of running biomechanics to the endurance performance. Furthermore, we explored different methods of estimating the distance covered in the Cooper test using a wearable global navigation satellite system (GNSS) receiver. Thirty-three runners (18 highly trained and 15 recreational) performed an incremental laboratory treadmill test to measure their maximum aerobic speed (MAS) and speed at the second ventilatory threshold (sVT2). They completed a 12-minute Cooper running test with foot-worm IMUs and a chest-worn GNSS-IMU on a running track 1-2 weeks later. Using the GNSS receiver, an accurate estimation of the 12-minute distance was obtained (accuracy of 16.5 m and precision of 1.1%). Using this distance, we showed a reliable estimation [R2 > 0.9, RMSE ϵ (0.07, 0.25) km/h] of the MAS and sVT2. Biomechanical metrics were extracted using validated algorithm and their association with endurance performance was estimated. Additionally, the high-/low-performance runners were compared using pairwise statistical testing. All performance variables, MAS, sVT2, and average speed during Cooper test, were predicted with an acceptable error (R2 ≥ 0.65, RMSE ≤ 1.80 kmh-1) using only the biomechanical metrics. The most relevant metrics were used to develop a biomechanical profile representing the running technique and its temporal evolution with acute fatigue, identifying different profiles for runners with highest and lowest endurance performance. This profile could potentially be used in standardized functional capacity measurements to improve personalization of training and rehabilitation programs.

Successful Return to Performance After COVID-19 Infection in an Elite Athlete.

PURPOSE: To present training load (TL) and heart-rate variability (HRV) in an elite sprinter monitored before, during, and after a COVID-19 infection until successful return to performance. METHODS: TL, subjective morning fatigue (MF), and supine HRV were monitored during a 12-week period. RESULTS: During a high-TL period (training camp), MF and heart rate increased and vagally mediated HRV variables decreased. MF increased and stayed high 3 days after the camp despite decrease in TL. In contrast, 4 days after the camp, heart rate decreased and vagally mediated HRV variables increased, reflecting parasympathetic hyperactivity. Elevated MF and suboptimal training performance led to a PCR test decision, which returned positive. After a 10-day training suspension, TL was progressively increased with low MF and high vagal tone. The athlete was able to return to competition 17 days after medical clearance for return to participation and 1 week later beat his indoor 60-m personal best. CONCLUSIONS: In this athlete, COVID-19 infection induced parasympathetic hyperactivity with subjective fatigue. This case report presents how performance capacity was only negatively influenced by a COVID-19 infection in the short term, with a quick and successful return to performance, thanks to state-of-the-art medical management. This highlights the importance of TL and HRV monitoring in return-to-participation and return-to-competition decisions.

Concurrent Evolution of Biomechanical and Physiological Parameters With Running-Induced Acute Fatigue.

Understanding the influence of running-induced acute fatigue on the homeostasis of the body is essential to mitigate the adverse effects and optimize positive adaptations to training. Fatigue is a multifactorial phenomenon, which influences biomechanical, physiological, and psychological facets. This work aimed to assess the evolution of these three facets with acute fatigue during a half-marathon. 13 recreational runners were equipped with one inertial measurement unit (IMU) on each foot, one combined global navigation satellite system-IMU-electrocardiogram sensor on the chest, and an Android smartphone equipped with an audio recording application. Spatio-temporal parameters for the running gait, along with the heart rate, its variability and complexity were computed using validated algorithms. Perceived fatigability was assessed using the rating-of-fatigue (ROF) scale at every 10 min of the race. The data was split into eight equal segments, corresponding to at least one ROF value per segment, and only level running parts were retained for analysis. During the race, contact time, duty factor, and trunk anteroposterior acceleration increased, and the foot strike angle and vertical stiffness decreased significantly. Heart rate showed a progressive increase, while the metrics for heart rate variability and complexity decreased during the race. The biomechanical parameters showed a significant alteration even with a small change in perceived fatigue, whereas the heart rate dynamics altered at higher changes. When divided into two groups, the slower runners presented a higher change in heart rate dynamics throughout the race than the faster runners; they both showed similar trends for the gait parameters. When tested for linear and non-linear correlations, heart rate had the highest association with biomechanical parameters, while the trunk anteroposterior acceleration had the lowest association with heart rate dynamics. These results indicate the ability of faster runners to better judge their physiological limits and hint toward a higher sensitivity of perceived fatigue to neuromuscular changes in the running gait. This study highlights measurable influences of acute fatigue, which can be studied only through concurrent measurement of biomechanical, physiological, and psychological facets of running in real-world conditions.

Predicting Hydration Status Using Machine Learning Models From Physiological and Sweat Biomarkers During Endurance Exercise: A Single Case Study.

Improper hydration routines can reduce athletic performance. Recent studies show that data from noninvasive biomarker recordings can help to evaluate the hydration status of subjects during endurance exercise. These studies are usually carried out on multiple subjects. In this work, we present the first study on predicting hydration status using machine learning models from single-subject experiments, which involve 32 exercise sessions of constant moderate intensity performed with and without fluid intake. During exercise, we measured four noninvasive physiological and sweat biomarkers including heart rate, core temperature, sweat sodium concentration, and whole-body sweat rate. Sweat sodium concentration was measured from six body regions using absorbent patches. We used three machine learning models to determine the percentage of body weight loss as an indicator of dehydration with these biomarkers and compared the prediction accuracy. The results on this single subject show that these models gave similar mean absolute errors, while in general the nonlinear models slightly outperformed the linear model in most of the experiments. The prediction accuracy of using the whole-body sweat rate or heart rate was higher than using core temperature or sweat sodium concentration. In addition, the model trained on the sweat sodium concentration collected from the arms gave slightly better accuracy than from the other five body regions. This exploratory work paves the way for the use of these machine learning models to develop personalized health monitoring together with emerging, noninvasive wearable sensor devices.

Short term high-intensity interval training in patients scheduled for major abdominal surgery increases aerobic fitness.

BACKGROUND: Prehabilitation may improve postoperative clinical outcomes among patients undergoing major abdominal surgery. This study evaluated the potential effects of a high-intensity interval training (HIIT) program performed before major abdominal surgery on patients' cardiorespiratory fitness and functional ability (secondary outcomes of pilot trial NCT02953119). METHODS: Patients were included before surgery to engage in a low-volume HIIT program with 3 sessions per week for 3 weeks. Cardiopulmonary exercise and 6-min walk (6MWT) testing were performed pre- and post-prehabilitation. RESULTS: Fourteen patients completed an average of 8.6 ± 2.2 (mean ± SD) sessions during a period of 27.9 ± 6.1 days. After the program, [Formula: see text]O2 peak (+ 2.4 ml min-1 kg-1, 95% CI 0.8-3.9, p = 0.006), maximal aerobic power (+ 16.8 W, 95% CI 8.2-25.3, p = 0.001), [Formula: see text]O2 at anaerobic threshold (+ 1.2 ml min-1 kg-1, 95%CI 0.4-2.1, p = 0.009) and power at anaerobic threshold (+ 12.4 W, 95%CI 4.8-20, p = 0.004) were improved. These changes were not accompanied by improved functional capacity (6MWT: + 2.6 m, 95% CI (- 19.6) to 24.8, p = 0.800). CONCLUSION: A short low-volume HIIT program increases cardiorespiratory fitness but not walking capacity in patients scheduled for major abdominal surgery. These results need to be confirmed by larger studies.

Feasibility of a prehabilitation program before major abdominal surgery: a pilot prospective study.

OBJECTIVE: To assess the feasibility of a prehabilitation program and its effects on physical performance and outcomes after major abdominal surgery. METHODS: In this prospective pilot study, patients underwent prehabilitation involving three training sessions per week for 3 weeks preoperatively. The feasibility of delivering the intervention was assessed based on recruitment and adherence to the program. Its impacts on fitness (oxygen uptake (VO2)) and physical performance (Timed Up and Go Test, 6-Minute Walk Test) were evaluated. RESULTS: From May 2017 to January 2020, 980 patients were identified and 44 (4.5%) were invited to participate. The main obstacles to patient recruitment were insufficient time (<3 weeks) prior to scheduled surgery (n = 276, 28%) and screening failure (n = 312, 32%). Of the 44 patients, 24 (55%) declined to participate, and 20 (23%) were included. Of these, six (30%) were not adherent to the program. Among the remaining 14 patients, VO2 at ventilatory threshold significantly increased from 9.7 to 10.9 mL/min/kg. No significant difference in physical performance was observed before and after prehabilitation. CONCLUSION: Although prehabilitation seemed to have positive effects on exercise capacity, logistic and patient-related difficulties were encountered. The program is not feasible in its current form for all-comers.