The Feasibility and Impact of a Presurgical Exercise Intervention Program (Prehabilitation) for Patients Undergoing Cystectomy for Bladder Cancer
The Feasibility and Impact of a Presurgical Exercise Intervention Program (Prehabilitation) for Patients Undergoing Cystectomy for Bladder Cancer
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DOI：
10.1016/j.urology.2020.05.104
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发表时间：
2020-11-01
期刊：
影响因子：
2.1
通讯作者：
Montgomery, Jeffrey S.
中科院分区：
文献类型：
--
作者：
Kaye, Deborah R.;Schafer, Christine;Montgomery, Jeffrey S.
目的 评估膀胱切除术患者预康复计划的可行性，并确定该计划在提高术中力量和功能能力方面的有效性。 材料和方法 这项 III 期研究招募了 2013 年 1 月至 2017 年 10 月期间≥60 岁、经活检证实患有膀胱癌、卡诺夫斯基评分≥70、采用久坐基线生活方式的患者，参加为期 4 周的监督术前运动训练计划。主要结果是可行性和安全性；次要结局包括健康状况的变化、患者报告的生活质量、笔手术并发症和再入院。进行了学生 t 检验和 Wilcoxon 符号秩检验。 结果 54 名患者参加了该计划。 51 名患者中的 41 名患者成功完成，定义为开始该计划并坚持 > 70% 的疗程的患者（80.4%，90% CI [71%-90%D）。没有不良事件。干预后健康状况和患者报告的生活质量得到改善，术后 90 天的一般和心理健康状况持续改善。主要限制是没有对照组。结论 膀胱切除术之前的预康复是可行的，安全，并导致患者力量、耐力的改善以及患者报告的生活质量相对基线的持续改善，有必要以扩大和随机的方式进一步评估预康复的影响 (C) 2020 Elsevier Inc.。
OBJECTIVE To assess the feasibility of a prehabilitation program for cystectomy patients and to determine the effectiveness of the program in improving strength and functional capacity in the pen-operative period.MATERIALS AND METHODS This phase III study accrued patients >= 60 years old from January 2013 to October 2017 with biopsy-proven bladder cancer, Karnofsky performance score >= 70 and a sedentary baseline lifestyle to participate in a 4-week supervised preoperative exercise training program. Primary outcomes were feasibility and safety; secondary outcomes included changes in fitness, patient-reported QOL, pen-operative complications and readmissions. Student's ttests and Wilcoxon signed-rank test were performed.RESULTS Fifty-four patients enrolled in the program. Successful completion, defined as patients who began the program and adhered to >70% of the sessions, was attained by 41 of 51 patients (80.4%, 90% CI [71%-90%D. There were no adverse events. Fitness and patient-reported QOL improved postintervention, with sustained improvements in general and mental health 90-days postsurgery. The primary limitation is no control group.CONCLUSION Prehabilitation prior to cystectomy is feasible, safe, and results in improvements in patient strength, endurance and sustained improvements in patient-reported QOL from baseline. Efforts to further evaluate the impact of prehabilitation in this population in an expanded and randomized fashion are warranted. (C) 2020 Elsevier Inc.