Physiotherapy Prehabilitation for cancer surgery patients.

Participants will participate in an initial assessment conducted by a senior physiotherapist to determine baseline exercise tolerance and other descriptors. This includes a 6 minute walking test (6MWT) and a balance/frailty assessment called a short physical performance battery (SPPB). A quality of life survey (QLQ C30) will also be assessed at this time. They will then participate in a 2x weekly, one hour in length duration tailored supervised exercise program. This is conducted by a senior physiotherapist and 4th year physiotherapy students from Curtin University. Participants recruited may be currently receiving neoadjuvant chemoradiotherapy (CRT), have finished CRT on not completing CRT. The intervention is carried out despite their current CRT as to not impact on their cancer care. It has already been proven that exercise is safe at any point within the patients' treatment journey and this is why this approach was taken. The program will consist of a walking program (determined from their 6MWT result) and resistance exercises via standard gymnasium equipment. The program is run as a group class, with a maximum of 10 participants per class. Their program will be documented and progressed / regressed as deemed appropriate by the supervising physiotherapist. The participants will be asked to exercise at a 'moderate intensity' which is described as 'difficulty walking and talking'. The walking program is implemented on a flat walking track within the hospital, and resistance exercises are completed on standard gymnasium equipment in the Physiotherapy gym. These include, upper limb exercise with free weights, sit to stand, step ups, calf raises, body weight push up, large muscle group exercise on gym equipment (leg press, latissimus dorsi pull down, tricep push, Smith machine etc). At the end of the 6 week program, the physiotherapist will repeat the initial assessment as a discharge assessment. As patients CRT treatment time / time to surgery differs for each surgical group - patients attend the surgical gym class for 6 weeks which is usually between 1-2 weeks pre-op. Adherence to the program is monitored via WebPAS - on online booking system used by the Physiotherapy clerks. Adherence is measured as appointments attended. Once the patient is discharged from hospital, we will record the patients’ length of stay in ICU and in hospital and post-operative complications occurred during their inpatient stay. If required, medical records will be pulled to allow for data collection.