Table 2.

Characteristics of prehabilitation studies of surgical management for colorectal cancer.

Author Year	Design	Description and Number of Participants (n)	Measured Outcomes	N-O Score	Jadad Score
Berkel et al. [26]; 2022	RCT	Colorectal cancer patients undergoing colorectal resection (n = 57)	Primary outcome: 30-day postoperative complication rate as determined by the Clavien–Dindo classification Secondary outcomes: Changes in preoperative aerobic fitness level, determined by VO2 at the VAT LOS Muscle strength, determined by handgrip strength and quadriceps strength Unplanned readmissions 30 and 90 days after surgery	N/A	3
Alejo et al. [29]; 2019	Non-randomized pilot study	Colorectal cancer patients undergoing neoadjuvant treatment (n = 12)	Primary outcome: Adherence to the intervention Secondary outcomes: Quality of life, determined by EORTC QoL questionnaire C-30 Anxiety and depression scores, determined utilizing the Hospital Anxiety and Depression Scale BMI Fitness level, using a one-mile walk for evaluation of cardiorespiratory fitness, as well as handgrip strength using a dynamometer, and a 5-repetition sit-to-stand test on a straight-backed chair Physical activity, assessed via spontaneous PA levels through accelerometry	7	N/A
Morielli et al. [30]; 2021	RCT	Rectal cancer patients to be treated with neoadjuvant CRT (n = 36)	Primary outcome: Cardiorespiratory fitness level, determined by VO2 peak while performing modified Bruce protocol stress test with direct gas exchange and ventilation measurements Secondary outcomes: Functional fitness, determined by Senior’s Fitness Test	N/A	3
West et al. [16]; 2015	Non-randomized, blinded pilot study	Rectal cancer patients to be treated with neoadjuvant CRT (n = 39)	Primary outcome: Oxygen uptake at lactate threshold, measured during CPET or bicycle exercise Secondary outcomes: Physical fitness, measured using PA monitor and averaged step count Exercise program’s safety and feasibility for high-risk patients	8	N/A
Moug et al. [31]; 2019	RCT	Rectal cancer patients to be treated with neoadjuvant CRT (n = 48)	Primary outcome: Feasibility and acceptability of the research procedures, determined by eligibility and recruitment rates Participant acceptability of randomization (percentage of participants attending baseline measurements after informed consent to participate) Participant retention rate and compliance with the physical activity intervention Secondary outcomes: Median step count per day Height Weight Hip and waist circumference Sit-to-stand test 6 MWT	N/A	3
Moug et al. [32]; 2020	RCT	Rectal cancer patients to be treated with neoadjuvant CRT (n = 44)	Primary outcome: Muscle mass, using total psoas area (TPA) measurement	N/A	3
Singh et al. [33]; 2017	Non-randomized pilot study	Rectal cancer patients planned for rectal resection (n = 12)	Primary outcome: Muscle strength, determined by chest press, seated row, leg press, and leg extension exercises using the 1-RM method Secondary outcomes: Physical performance assessed using usual and fast 6 m walk, 6 m backwards walk, repeated chair rise, stair climb, and the 400 m walk tests Body composition, using LBM, FBM using dual-energy X-ray absorptiometry Fatigue, determined by the validated 30-item short form of the Multidimensional Fatigue Symptom Inventory QoL, determined by EORTC QoL questionnaire C-30	6	N/A
Singh et al. [34]; 2018	Non-randomized pilot study	Rectal cancer patients to be treated with neoadjuvant CRT (n = 10)	Primary outcomes: Muscular strength, evaluated by performing chest press, seated row, leg press, and leg extension using the 1-RM method Muscular endurance, determined by the number of maximum repetitions performed at 70% of the pre-exercise 1-RM weight for chest press and leg press Physical performance, assessed using usual and fast 6 m walk, 6 m backwards walk, repeated chair rise, stair climb, and the 400 m walk	6	N/A
Heldens et al. [35]; 2016	Non-randomized pilot study	Rectal cancer patients to be treated with neoadjuvant CRT (n = 13)	Primary outcome: Functional exercise capacity using the 6 MWT Secondary outcomes: Muscle strength, measured by leg extension and chest press submaximal multiple-repetition (X-RM) test Perception of fatigue, assessed by multidimensional fatigue index (MFI) Perception of QoL, assessed using the SF-36 questionnaire	6	N/A
Loughney et al. [36]; 2017	Non-randomized pilot study	Rectal cancer patients to be treated with neoadjuvant CRT (n = 39)	Primary outcome: PA level, determined by 72 h monitoring using SenseWear biaxial accelerometer	7	N/A
Gillis et al. [37]; 2019	RCT	Colorectal cancer patients planned for colorectal resection (n = 139)	Primary outcomes: Change in LBM, measured using a multi-frequency bioelectrical impedance analysis (BIA) Functional exercise capacity using the 6 MWT Intervention compliance, assessed by patient-filled diary	N/A	3
Gillis et al. [38]; 2016	RCT	Colorectal cancer patients planned for colorectal resection (n = 48)	Primary outcome: Changes in functional walking capacity measured using 6 MWT Secondary outcomes: Self-reported PA, assessed using the CHAMPS questionnaire Health-related quality of life, assessed using the SF-36 questionnaire	N/A	3
Furyk et al. [39]; 2021	RCT	Frail colorectal cancer patients planned for colorectal resection (n = 106)	Primary outcome: Changes in functional walking capacity measured using 6 MWT Secondary outcome: PA level, using accelerometry Health-related QoL, assessed using EQ-5D, short-form 12 and modified Barthel index. Post-surgical complications	N/A	3
Bousquet-Dion et al. [40]; 2018	RCT	Colorectal cancer patients planned for colorectal resection (n = 80)	Primary outcomes: Functional exercise capacity measured with 6 MWT Secondary outcomes: Self-reported PA, assessed using the CHAMPS questionnaire	N/A	3
Tweed et al. [41]; 2021	Non-randomized pilot study	Colorectal cancer patients planned for colorectal resection (n = 9)	Primary outcome: Viability of prehabilitation program defined as ≥80% compliance with the exercise and nutritional program Secondary outcomes: organizational viability acceptability of the prehabilitation program, assessed using a questionnaire functional capacity after prehabilitation, determined by CPET measures on a calibrated electronically braked cycle ergometer muscle strength, determined by handgrip strength LOS Postoperative complication rate Readmission rate 30-day and 1-year mortality rates	6	N/A
Klerk et al. [42]; 2021	Retrospective cohort study	Colorectal cancer patients planned for colorectal resection (n = 351)	Primary outcome: Postoperative complications rate Secondary outcomes: Unplanned readmission rate LOS Mortality rate	8	N/A
Arias et al. [27]; 2021	RCT	Colorectal cancer patients planned for colorectal resection (n = 20)	Primary outcomes: LOS Occurrence of postoperative complications Changes in LBM. determined using the MF-BIA device Changes in FBM, determined using MF-BIA device	N/A	3
Karlsson et al. [43]; 2019	RCT	Colorectal cancer patients planned for colorectal resection (n = 23)	Primary outcome: Process feasibility evaluated with the variables recruitment rate, exercise compliance, and acceptability Secondary outcomes: Scientific feasibility including treatment safety, description of dose level and response, and estimation of treatment results	N/A	3
West et al. [44]; 2019	Non-randomized pilot study	Colorectal cancer patients to be treated with neoadjuvant CRT (n = 35)	Primary outcomes: Tumor regression, as expressed by ypT, ypTRG Oxygen uptake at lactate threshold	7	N/A
Li et al. [17]; 2013	Non-randomized pilot study	Colorectal cancer patients planned for colorectal resection (n = 87)	Primary outcomes: Functional walking capacity, as determined by 6 MWT Secondary outcomes: Complication rate, graded using the Clavien–Dindo classification Self-reported PA, assessed by CHAMPS short form questionnaire Health-related QoL, assessed using the SF-36 questionnaire	8	N/A

RCT—randomized controlled trial; N/A—not applicable; VAT—ventilatory anaerobic threshold; QoL—quality of life; EORTC - European Organization for Research and Treatment of Cancer; BMI—body mass index; CRT—chemoradiotherapy; 6 MWT—6-minute walking test; SF-36—36-Item Short-Form Health Survey; CCI—comprehensive complication index; PA—physical activity; CHAMPS—Community Healthy Activities Model Program for Seniors; CPET—cardiopulmonary exercise testing; LBM—lean body mass; MF-BIA- multi-frequency bioelectrical impedance analysis; FBM—fat body mass; ypTRG—postoperative pathological tumor regression stage; ypT-stage—postoperative tumor stage pathology; 1-RM—1 repetition maximum.