Effect of Short-Term Homebased Pre- and Postoperative Exercise on Recovery after Colorectal Cancer Surgery (PHYSSURG-C): A Randomized Clinical Trial.

Objective To determine the effect of a short-term, unsupervised exercise intervention before and after colorectal cancer surgery on self-assessed physical recovery. Summary background data Preoperative exercise interventions could help improve recovery after colorectal cancer surgery and is currently recommended. Methods A randomized, parallel, open-label trial in six university or regional hospitals in Sweden. Inclusion criteria were age ≥20 years and planned elective colorectal cancer surgery. Participants were randomised to either a physical activity intervention with aerobic activity and inspiratory muscle training two weeks pre- and four weeks postoperatively or usual care. The primary outcome measure was self-assessed physical recovery four weeks postoperatively. Analyses were performed according to intention to treat. Outcome assessors were masked regarding the intervention while both participants and physiotherapists were informed due to the nature of the intervention. Results Between Jan 22, 2015, and May 28, 2020, 761 participants were recruited and assigned to either intervention (I) (n = 379) or control (C) (n = 382). After exclusions 668 participants (I = 317, C = 351) were included in the primary analysis. There was no effect from the intervention on the primary outcome measure (adjusted odds ratio (OR) 0.84, 95% confidence interval (CI) 0.62 - 1.15) with 13% and 15% of participants feeling fully physically recovered in I and C respectively. There were no reported adverse events. Conclusions There was no effect from a physical activity intervention before and after colorectal cancer surgery on short-term self-assessed physical recovery. The results from this study call for reconsiderations regarding current recommendations for preoperative physical activity interventions.