A Multicentre, Pilot Randomized Controlled Trial to Examine the Effects of Prehabilitation on Functional Outcomes After Radical Prostatectomy
Overview
- Phase
- Phase 1
- Intervention
- Not specified
- Conditions
- Prostate Cancer Patients Undergoing Radical Prostatectomy
- Sponsor
- University of Guelph-Humber
- Enrollment
- 86
- Locations
- 2
- Primary Endpoint
- Contamination
- Status
- Completed
- Last Updated
- 8 years ago
Overview
Brief Summary
Radical prostatectomy is the most common and effective treatment for localized prostate cancer. Unfortunately, radical prostatectomy is associated with significant adverse effects, such as urinary incontinence, sexual dysfunction, and reduced physical function that collectively diminish health-related quality of life which may persist for up to two years postoperatively. The primary objective of this trial is to assess the feasibility of conducting of a multi-site randomized controlled trial to test the effect of a comprehensive prehabilitation program versus standard care for men with prostate cancer undergoing radical prostatectomy. We hypothesize that men with prostate cancer undergoing radical prostatectomy in the comprehensive prehabilitation program (full-body exercises and pelvic floor muscle exercises) will report better health-related quality of life, urological symptoms, and physical fitness, physical activity, and pain, as well as a shorter postoperative length of stay than participants receiving standard preoperative care (pelvic floor muscle exercises alone). Our secondary objective is to report estimates of efficacy on several clinically important outcomes for this population that will be used for sample size calculations in an adequately powered trial.
Investigators
Daniel Santa Mina
Program Head
University of Guelph-Humber
Eligibility Criteria
Inclusion Criteria
- •Men with localized prostate cancer (stage cT1- cT2) who have consented for radical prostatectomy
- •between the ages of 40 and 80 years.
Exclusion Criteria
- •i) severe coronary artery disease (Canadian Cardiovascular Society class III or greater);
- •ii) significant congestive heart failure (New York Heart Association class III or greater);
- •iii) uncontrolled pain;
- •iv) neurological or musculoskeletal co-morbidity inhibiting exercise;
- •v) diagnosed psychotic, addictive, or major cognitive disorders;
- •vi) no more than two of the following Coronary Risk Factors as defined by the American College of Sports Medicine : family history of coronary disease, cigarette smoking, hypertension (SBP \> 140 mmHg; DBP \> 90 mmHg), known dyslipidemia, known impaired fasting, glucose (\>110 mg/dL), obesity (BMI \> 30 kg/m2 or waist circumference \> 102cm), or physically inactive (\<150 min of moderate intensity physical activity per week).
Outcomes
Primary Outcomes
Contamination
Time Frame: 26 weeks postoperatively
The same exercise logbook questions that ask about aerobic and resistance exercise, and pelvic floor muscle exercises, will be administered to both groups to assess contamination.
Study Retention
Time Frame: 26 weeks postoperatively
Retention will be assessed by measuring attrition throughout the intervention period and at each assessment.
Recruitment
Time Frame: When recruitment is complete (approximately 12 months after study initiation; January 2015)
Prior exercise trials in prostate cancer patients on hormone and/or radiation therapy have observed recruitment rates of 25-40%, but no studies have assessed recruitment to a preoperative exercise intervention among prostate cancer survivors. We will measure recruitment-success percentage and will record reasons for non-participation to better understand why men electing radical prostatectomy would not participate in an exercise intervention.
Adherence to Prehabilitation Program
Time Frame: 26 weeks postoperatively
Adherence to the home-based exercise program (aerobic and resistance) and pelvic floor muscle exercises will be measured through a logbook completed by the research coordinator during weekly communication.
Secondary Outcomes
- Quality of Life(At baseline, within 1 week prior to surgery, and at 4, 12, and 26 weeks postoperatively.)
- Psychosocial Wellbeing(At baseline, within 1 week prior to surgery, and at 4, 12, and 26 weeks postoperatively.)
- Length of stay(From time of surgery to discharge (typically 1 week))
- Physical Fitness(At baseline, within 1 week prior to surgery, and at 4, 12, and 26 weeks postoperatively.)
- Physical Activity(At baseline, within 1 week prior to surgery, and at 4, 12, and 26 weeks postoperatively.)
- Treatment Complications(26 weeks postoperatively)