Table 1.

The exercise-based rehabilitation program. Efficacy of a multidisciplinary rehabilitation program for patients undergoing radical cystectomy, Aarhus University Hospital, 2011–2013, Denmark

Preoperative outpatient optimization from inclusion to surgery (−14 days)	Postoperative in-hospital optimization Day 0–7+
Information • Information about standard goals for patient involvement concerning mobilization, exercise training and managing urinary diversion. • Standardized information about the interactions among lifestyle aspects, alcohol and smoking, nutritional status, and physical activity. • Provision of supplementary written information. • Discussion of mutual expectations and motivation.	Mobilization • Instructions for getting out of bed. • Aggressive and progressive standardized mobilization plans, including:  – Scheduled time out of bed increasing from 3 hours on day 1 after surgery to 8 hours on the fourth postoperative day.  – Walking distance increasing from 125 m on the day after surgery to 1000 m on the fourth postoperative day. • Encouragement to follow fixed standard goals for mobilization and walking. • Registration of daily mobilization and walking activities in a patient diary. • Evaluation of ability to perform personal activities of daily living using the Katz score.34
Exercise-based prehabilitation program • A standardized written exercise program was introduced and distributed by the MDT-physical therapist. Patients were instructed to perform the exercise training program twice daily. • The exercise program included the following:  – Step training on a step trainer (15 minutes per training session). The step trainer was delivered from the hospital.  – Six different muscle strength and endurance exercises. The number of repetitions was individualized, and patients were encouraged to progress through the training program by increasing the number of exercise repetitions. • A patient diary was distributed, and patients were instructed to record the number of training sessions and number of exercise repetitions daily. • Evaluation.	Exercise-based rehabilitation program • Physical therapy was provided twice per day for the first 7 postoperative days. • The physical therapy sessions included the following:  – Respiratory and circulatory exercises.  – Mobilization in and out of bed.  – Walking.  – Supervised standardized progressive muscle strength and endurance training. • Evaluation.
Follow-up • A proactive telephone call after 1 week to ensure adherence to the program. • In case of questions, patients could contact the MDT.	Follow-up • Discharged with a home training exercise program. • In case of questions, patients could contact the MDT.

Abbreviation: MDT, multidisciplinary team.