Abstract
Purpose: Our aim was to examine the efficacy of concurrent exercise (i.e., aerobic and strength exercise) during prehabilitation programs on functional capacity in comparison with standard cancer care strategies in colorectal cancer (CRC) patients scheduled for surgery. Methods: A systematic review of randomized controlled trials was performed. A search of electronic databases [PubMed, Web of Science, and EBSCO Host] was conducted to identify all publications employing concurrent exercise in patients with CRC. Random-effects meta-analyses were used to calculate the standardized change in mean difference (SMD) and 95%CI between exercise intervention and control groups for the 6 min walking test (6MWT) distance covered before and after prehabilitation. Results: Six studies met the inclusion criteria (379 patients with CRC). Concurrent training during prehabilitation led to significant positive effects on the 6MWT (0.28 SMD [0.03-0.54], p = 0.037). Subgroup analyses showed a higher SMD (0.48 [0.00-0.98], p = 0.050) in younger (i.e., <70 years) CRC patients compared to their older counterparts (0.10 [0.08-0.11], p = 0.310). Meta-regression models between SMD of the 6MWT and body mass index, prehabilitation program duration, and baseline 6MWT distance covered did not show any significant relationship. Conclusions: This meta-analysis demonstrates the superiority of concurrent exercise prehabilitation in improving functional capacity related to cardiometabolic changes and lowering postoperative risk in patients with CRC.