The effects of physical prehabilitation in elderly patients undergoing colorectal surgery: a systematic review
Open accessAbstract
Aim: Prehabilitation, defined as enhancement of the preoperative condition of a patient, is a possible strategy for improving postoperative outcome. Lack of muscle strength and poor physical condition, increasingly prevalent in older patients, are risk factors for postoperative complications. Eighty‐five per cent of patients with colorectal cancer are aged over 60 years. Since surgery is the cornerstone of their treatment, this review systemically examined the literature on the effect of physical prehabilitation in older patients undergoing colorectal surgery. Method: Trials and case–control studies investigating the effect of physical prehabilitation in patients over 60 years undergoing colorectal surgery were retrieved from MEDLINE, EMBASE , CINAHL and the Cochrane library. Patient characteristics, the type of intervention and outcome measurements were recorded. The risk of bias and heterogeneity was assessed. Results: Five studies including 353 patients were identified. They were small, containing an average of 77 patients and were of moderate methodological quality. Compliance rates of the prehabilitation programme varied from 16 to 97%. None of the studies could identify a significant reduction of postoperative complications or length of hospital stay. Four studies showed physical improvement (walking distance, respiratory endurance) in the prehabilitation group. Clinical heterogeneity precluded a meta‐analysis. Conclusion: Prehabilitation is a possible means of enhancing the physical condition of patients preoperatively. The quality of studies in older patients undergoing colorectal surgery is poor, despite the increase in elderly people with colorectal cancer. Defining specific patient groups at risk and standardizing the outcome are essential for improving the results of treatment.
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Only about 7% of published randomized trials currently target older adults with cancer.
“Currently, only about 7% of published randomized trials target older adults with cancer [32].”
From Pilot study of a telehealth perioperative physical activity intervention for older adults with cancer and their caregivers (2020) · cites this paper as [32]
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- Authors
- Bruns, E. R. J., van den Heuvel, B., Buskens, C. J., van Duijvendijk, P., Festen, S., Wassenaar, E. B., van der Zaag, E. S., Bemelman, W. A., & van Munster, B. C.
- Affiliations
- Gelre Hospitals (NL)
- Department of Surgery VU Medical Centre Amsterdam the Netherlands
- Amsterdam UMC Location University of Amsterdam (NL)
- Department of Surgery Gelre Hospitals Apeldoorn the Netherlands
- University Medical Center Groningen (NL)
- Department of Medicine University Medical Centre Groningen the Netherlands
- Corresponding author
- Bruns, E. R. J.
- Venue
- Colorectal Disease
- Publisher
- Wiley
- Published
- 2016-08
- Volume
- 18
- Issue
- 8
- Pages
- O267-77
- ISSN
- 1462-8910 (ISSN-L)
- 1463-1318
- OpenAlex
- W2462301047
- Cited by
- 200
- References
- 57
- Citations by year
- 2026: 12 · 2025: 7 · 2024: 21 · 2023: 16 · 2022: 37 · 2021: 28 · 2020: 26 · 2019: 25 · 2018: 13 · 2017: 13 · 2016: 1
- FWCI
- 3.44
- Type
- journal article
- Language
- en
- Open access
- green
- pure.amsterdamumc.nl
- Licence
- Locations
- Colorectal Disease (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Lirias (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Keywords
- prehabilitation, elderly patients, colorectal surgery, colorectal cancer, postoperative complications, length of hospital stay, muscle strength, physical fitness, respiratory endurance, walking distance
- MeSH terms
- Walk Test, Aged, Exercise Therapy, Humans, Length of Stay, Physical Endurance, Postoperative Complications, Preoperative Care, Digestive System Surgical Procedures, Colorectal Neoplasms
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