biostudies-literatureLoughney LNational Institute for Health Research - Research for Patient Benefit Programme.23https://www.ebi.ac.uk/biostudies/studies/S-EPMC8216760biostudies-literatureUnknown10(1)<h4>Background</h4>The EMPOWER trial aimed to assess the effects of a 9-week exercise prehabilitation programme on physical fitness compared with a usual care control group. Secondary aims were to investigate the effect of (1) the exercise prehabilitation programme on psychological health; and (2) neoadjuvant chemoradiotherapy (NCRT) on physical fitness and psychological health.<h4>Methods</h4>Between October 2013 and December 2016, adults with locally advanced rectal cancer undergoing standardised NCRT and surgery were recruited to a multi-centre trial. Patients underwent cardiopulmonary exercise testing (CPET) and completed HRQoL questionnaires (EORTC-QLQ-C30 and EQ-5D-5L) pre-NCRT and post-NCRT (week 0/baseline). At week 0, patients were randomised to exercise prehabilitation or usual care (no intervention). CPET and HRQoL questionnaires were assessed at week 0, 3, 6 and 9, whilst semi-structured interviews were assessed at week 0 and week 9. Changes in oxygen uptake at anaerobic threshold (VO₂ at AT (ml kg^-1 min^-1)) between groups were compared using linear mixed modelling.<h4>Results</h4>Thirty-eight patients were recruited, mean age 64 (10.4) years. Of the 38 patients, 33 were randomised: 16 to usual care and 17 to exercise prehabilitation (26 males and 7 females). Exercise prehabilitation significantly improved VO₂ at AT at week 9 compared to the usual care. The change from baseline to week 9, when adjusted for baseline, between the randomised groups was + 2.9 ml kg ^-1 min ^-1; (95% CI 0.8 to 5.1), p = 0.011.<h4>Conclusion</h4>A 9-week exercise prehabilitation programme significantly improved fitness following NCRT. These findings have informed the WesFit trial (NCT03509428) which is investigating the effects of community-based multimodal prehabilitation before cancer surgery.<h4>Trial registration</h4>ClinicalTrials.gov NCT01914068 . Registered 1 August 2013.Perioperative medicine (London, England)The effects of neoadjuvant chemoradiotherapy and an in-hospital exercise training programme on physical fitness and quality of life in locally advanced rectal cancer patients: a randomised controlled trial (The EMPOWER Trial).PMC8216760PB-PG-0711-25093Loughney LMythen MGWest MACox THawkins LKemp GJBarben CPCalverley PMFit4Surgery groupVarkonyi-Sepp JBurke SBates APalmer DHMoyses HGrocott MPWJack SfalseThe effects of neoadjuvant chemoradiotherapy and an in-hospital exercise training programme on physical fitness and quality of life in locally advanced rectal cancer patients: a randomised controlled trial (The EMPOWER Trial).<h4>Background</h4>The EMPOWER trial aimed to assess the effects of a 9-week exercise prehabilitation programme on physical fitness compared with a usual care control group. Secondary aims were to investigate the effect of (1) the exercise prehabilitation programme on psychological health; and (2) neoadjuvant chemoradiotherapy (NCRT) on physical fitness and psychological health.<h4>Methods</h4>Between October 2013 and December 2016, adults with locally advanced rectal cancer undergoing standardised NCRT and surgery were recruited to a multi-centre trial. Patients underwent cardiopulmonary exercise testing (CPET) and completed HRQoL questionnaires (EORTC-QLQ-C30 and EQ-5D-5L) pre-NCRT and post-NCRT (week 0/baseline). At week 0, patients were randomised to exercise prehabilitation or usual care (no intervention). CPET and HRQoL questionnaires were assessed at week 0, 3, 6 and 9, whilst semi-structured interviews were assessed at week 0 and week 9. Changes in oxygen uptake at anaerobic threshold (VO₂ at AT (ml kg^-1 min^-1)) between groups were compared using linear mixed modelling.<h4>Results</h4>Thirty-eight patients were recruited, mean age 64 (10.4) years. Of the 38 patients, 33 were randomised: 16 to usual care and 17 to exercise prehabilitation (26 males and 7 females). Exercise prehabilitation significantly improved VO₂ at AT at week 9 compared to the usual care. The change from baseline to week 9, when adjusted for baseline, between the randomised groups was + 2.9 ml kg ^-1 min ^-1; (95% CI 0.8 to 5.1), p = 0.011.<h4>Conclusion</h4>A 9-week exercise prehabilitation programme significantly improved fitness following NCRT. These findings have informed the WesFit trial (NCT03509428) which is investigating the effects of community-based multimodal prehabilitation before cancer surgery.<h4>Trial registration</h4>ClinicalTrials.gov NCT01914068 . Registered 1 August 2013.2021-01-01T00:00:00Z2021 Jun2022-02-10T16:25:54.253Z2022-02-10T16:25:54.253ZS-EPMC82167603415467510.1186/s13741-021-00190-8