Effect of two different pre-operative exercise training regimens before colorectal surgery on functional capacity: A randomised controlled trial.
Eur J Anaesthesiol
; 37(11): 969-978, 2020 11.
Article
em En
| MEDLINE
| ID: mdl-32976204
ABSTRACT
BACKGROUND:
Multimodal prehabilitation, including exercise training, nutritional therapy and anxiety reduction, has been shown to attenuate functional decline associated with surgery. Due to the growing interest in functional status as a targeted surgical outcome, a better understanding of the optimal prescription of exercise is critical.OBJECTIVE:
The objective is to compare peri-operative functional trajectory in response to two different exercise training protocols within a 4-week, supervised, multimodal prehabilitation programme.DESIGN:
This was a single blinded, single centre, randomised controlled study. Participants performed four assessments at baseline, after prehabilitation (just before surgery), and at 1 and 2 months after surgery. PATIENTS Adult patients scheduled for elective resection of nonmetastatic colorectal cancer were included provided there were no absolute contraindications to exercise nor poor language comprehension. INTERVENTION Patients followed either high-intensity interval training (HIIT), or moderate intensity continuous training (MICT), as part of a 4-week multimodal prehabilitation programme. Both groups followed the same supervised resistance training, nutritional therapy and anxiety reduction interventions. All patients followed standardised peri-operative management. MAIN OUTCOMEMEASURE:
Changes in oxygen consumption at anaerobic threshold, measured with sequential cardio-pulmonary exercise testing, were assessed and compared between groups.RESULTS:
Forty two patients were included in the primary analysis (HIIT nâ=â21 vs. MICT nâ=â21), with meanâ±âSD age 64.5â±â11.2 years and 62% were men. At 2 months after surgery, 13/21 (62%) in HIIT and 11/21 (52%) in MICT attended the study visits. Both protocols significantly enhanced pre-operative functional capacity, with no difference between groups mean (95% confidence interval) oxygen consumption at anaerobic threshold 1.97 (0.75 to 3.19)âmlâkgâmin in HIIT vs. 1.71 (0.56 to 2.85) in MICT, Pâ=â0.753. At 2 months after surgery, the HIIT group showed a higher improvement in physical fitness 2.36 (0.378 to 4.34)âmlâkgâmin, Pâ=â0.021. No adverse events occurred during the intervention.CONCLUSION:
Both MICT and HIIT enhanced pre-operative functional capacity. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT03361150.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cirurgia Colorretal
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Treinamento Intervalado de Alta Intensidade
Tipo de estudo:
Clinical_trials
/
Guideline
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur J Anaesthesiol
Assunto da revista:
ANESTESIOLOGIA
Ano de publicação:
2020
Tipo de documento:
Article