Surgery prehabilitation

Case study: Improving patient readiness for major surgery through prehabilitation

Staff: Dr Garry Tew, Professor John Saxton, Dr Gabriel Cucato, Dr Jenni Naisby

Major surgery elicits a huge strain on the body. Exercise scientists from Northumbria University have demonstrated that exercise-based prehabilitation programmes can help vascular and cancer patients to cope with this strain by safely improving physical fitness and other risk factors in the weeks leading up to surgery. This research directly secured GBP1,900,000 in funding and led to the launch of the PREPARE-ABC clinical trial. This enabled 23 colorectal cancer hospital units across the UK to establish new prehabilitation services. By October 2020, 400 patients received exercise support through this programme, leading to improved health outcomes. In North East England, a new community-based service called PREPWELL was established in 2018 and over 30 clinicians from James Cook University Hospital, Middlesbrough, referred 171 patients for individualised prehabilitation support, leading to improved patient outcomes. Patients previously deemed as ‘unfit’ for aortic aneurysm surgery were able to improve fitness through prehabilitation, successfully undergo surgery, and recover without complications. Find out more

Underpinning research

Garry Tew, Batterham, A.M., Colling, K., Gray, J., Kerr, K., Kothmann, K., Nawaz, S., Weston, M., Yates, D. and Danjoux, G. (2017) ‘Randomized feasibility trial of high-intensity interval training before elective abdominal aortic aneurysm repair’ The British Journal of Surgery 104(13): 1791-1801

Garry Tew, Ayyash, R., Durrand, J. and Danjoux, G.R. (2018) ‘Clinical guideline and recommendations on pre-operative exercise training in patients awaiting major non-cardiac surgery’ Anaesthesia 73(6): 750-768

Banerjee, S., Manley, K., Shaw, B., Lewis, L., Gabriel Cucato, Mills, R., Rochester, M., Clark, A., and John Saxton (2018) ‘Vigorous intensity aerobic interval exercise in bladder cancer patients prior to radical cystectomy: a feasibility randomised controlled trial’ Support Care Cancer 26: 1515-1523

Banerjee, S., Semper, K., Skarparis, K., Jenni Naisby, Lewis, L., Gabriel Cucato, Mills, R., Rochester, M. and John Saxton (2019) ‘Patient perspectives of vigorous intensity aerobic interval exercise prehabilitation prior to radical cystectomy: a qualitative focus group study’ Disability and Rehabilitation 14: 1-8

Faithfull, S., Turner, L., Poole, K., Joy, M., Manders, R., Weprin, J., Winters-Stone, K., and John Saxton (2019). ‘Prehabilitation for adults diagnosed with cancer’ European Journal of Cancer Care 28(4): e13023