Authors: (including presenting author): :
Chau CKW(1), Wong SCL(1), Chung KHL(1), Tsui AYY(1), Chu CWH(2), Lau CH(2), Hau ESM(2), Kwan WF(2), Yuen SL(2) and Chan ACM(1)
Affiliation: :
(1)Physiotherapy Department, Queen Elizabeth Hospital,(2)Department of Surgery, Queen Elizabeth Hospital
Keyword 1: :
Physiotherapy
Keyword 2: :
Colorectal surgery
Keyword 4: :
Prehabilitation
Keyword 5: :
Postoperative rehabilitation
Keyword 6: :
Physical Fitness
Introduction: :
Physiotherapy plays a crucial role in surgical rehabilitation, and its importance cannot be overstated. Major abdominal operations, such as colorectal surgery, could affect physical function and overall well-being substantially, especially for the frail elderly. Successful surgical rehabilitation in the patient journey starts from prehabilitation to optimizing fitness before surgery, early mobilization after surgery to reduce complications, followed by targeted exercises for post-surgical recovery.
Objectives: :
A retrospective study to evaluate the impact of a comprehensive physiotherapy program on the physical fitness of patients with colorectal surgery
Methodology: :
From October 2022 to November 2025, patients with a diagnosis of colorectal cancer under Enhanced Recovery After Surgery(ERAS) Program were assessed. Patients with known respiratory diseases, active or chronic ex-smokers, impaired exercise capacity were recruited into a comprehensive physiotherapy program. Outcome measures included six-minute walk distance(6MWD), maximal short exercise capacity(MSEC) and predicted peak oxygen consumption(VO2peak) from Modified Steep Ramp Test, health-related quality of life (HRQOL) from Functional Assessment of Cancer Therapy – General and Colorectal (FACT-G and FACT-C) were evaluated among 4 time points: before (T1) and after (T2) prehabilitation; and before (T3) and after (T4) post-operative rehabilitation. Data were analyzed with repeated measures of ANOVA and Friedman Test
Result & Outcome: :
Data of 108 patients aged 71.23 ± 9.11 (57 males and 51 females) underwent colorectal surgery were retrieved. Mean prehabilitation and rehabilitation sessions were 8.27±3.03 and 23.8±13.57 respectively. Functional exercise capacity revealed by 6MWD, MSEC and predicted VO2peak all showed significant improvements (p< 0.05). Positive improvements of 52.64±9.64metres in 6MWD, 22.22±3.73Watt in MSEC and 2.08±0.33mLkg-1min-1 in predicted VO2peak after prehabilitation while 34.88±9.24metres in 6MWD, 14.10±3.15Watt in MSEC and 1.10±0.34mLkg-1min-1 in predicted VO2peak after rehabilitation. HRQOL also showed significant positive improvements (p< 0.05) with improved scores of 6.69±1.41 in FACT-G and 9.57±1.68 in FACT-C after prehabilitation while 5.22±1.40 in FACT-G and 6.84±1.63 in FACT-C after rehabilitation. Upon completion of program at T4, encouraging results were observed with the 6MWD and the predicted VO2peak returned to the pre-operative optimum level at T2 (p=0.98). Comprehensive physiotherapy program in ERAS enhances patient outcomes throughout the journey of colorectal surgery and provided evidence to local implementation. In addition, risk stratification of patients allows better allocation of resources to optimize outcomes and enhance overall satisfaction and compliance.
