Feasibility of Home-based Preoperative Exercise in Older People

Not Applicable

Completed

Brief Summary: The purpose of the study is to evaluate the feasibility of recruitment procedure, intervention including compliance and the collaboration between in- and out patient clinics of preoperative home-based exercise in older people before colorectal surgery.

Detailed Description: The feasibility study will be conducted in order to evaluate the study design of a future RCT. Feasibility data will eg. consist of study flow description, number of eligible participants, included participants, patients and instructors satisfaction with the intervention, training compliance, reasons for drop-outs, and adverse events.

Patients waiting for colorectal surgery will be recruited and included after informed consent. Physical and respiratory function will be assessed at the hospital before the intervention, the day before surgery and the day before discharge. Data on postoperative complications, length of stay and mortality will be collected during the hospital stay. At baseline and six months after surgery, the participants will receive three questionnaires about level of independence in daily living, physical activity and health related quality of life. The intervention will be performed in the older person's home and consists of a combination of high-intensity respiratory training and individually adjusted functional exercise. Both groups will receive physical activity advice and malnutrition will be screened to optimize their nutritional status.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Health status that contradicts participation in the study such as unstable heart disease or severe orthopaedic conditions that prohibits training and severe systematic illness.

Arm && Interventions

Group	Intervention	Description
Control group	Exercise	The participants will receive ordinary preoperative information, but will also be encouraged to follow the recommendation of 150 minutes/week of moderate physical activity.
Exercise group	Exercise	The sessions will be led by a physiotherapist, in the older person's home. The sessions will consist of inspiratory muscle training with a resistance starting from 50% of their maximal capacity (30 breathes, 2 times/day). The training session will also consist of high-intensity individually adjusted functional strength and endurance training: chair-stand; stair climb/step up with weight belts, interval walking indoor and/or outdoor. This will be combined with functional task-exercises. The training will be conducted 2-3 times week, for at least two weeks or until they undergo surgery. During the remaining days, the participants will be instructed to follow the recommendation of 30 minutes of moderate physical activity per day, as well as to perform inspiratory muscle training.

Primary Outcome Measures

Name	Time	Method
Recruitment Rate	Baseline	The recruitment rate is calculated by the number of participants allocated to either the exercise group or control group from the total number of eligible participants (n=66).
Exercise Compliance	At the end of the intervention, after 2-4 weeks	Compliance with the exercise intervention was defined as the number of sessions attended out of planned sessions and was registered in the exercise logs by the physiotherapists in primary care. Only participants randomized to the exercise group were evaluated for this assessment.
Acceptability	At the end of the intervention, after 2-4 weeks	Patients and instructors satisfaction with the intervention measured with a survey. Instructors were not enrolled. Only participants randomized to the exercise group were evaluated for this assessment.
Adverse Events	During the intervention, after 1-4 weeks	Musculoskeletal-related events, cardiovascular episodes, falls and health care use that occurred during the exercise intervention before (pre)-surgery. Adverse events are only reported for the intervention group since the control group were a treatment as usual (TAU) group.

Secondary Outcome Measures

Name	Time	Method
Six-minute Walk	Baseline, before surgery (after 2-4 weeks), before discharge app 4-10 days after surgery	Meters completed, effort estimated
Inspiratory Muscle Strength	Baseline, before surgery (after 2-4 weeks), before discharge app 4-10 days after surgery	Inspiratory muscle strength measured with MicroRPM.
Chair-stand 30-sec	Baseline, before surgery (after 2-4 weeks), before discharge app 4-10 days after surgery	Number of stands during 30 sec.
Walking Speed	Baseline, before surgery (after 2-4 weeks), before discharge app 4-10 days after surgery	Normal walking speed was measured over 10 meters.
Postoperative Complications	Within the first 30 days of surgery	Clavien-Dindo, number of participants with at least one postoperative complication.
Length of Stay	At discharge, 2-4 weeks after baseline	Number of days admitted to the hospital