Eur J Phys Rehabil Med 2024 Feb 28;60(1):145–153

Table I. —Treatment strategies described by Heil et al., [12] used in their study to determine the effectiveness of a multimodal prehabilitation program compared with usual care in high-risk patients with colorectal cancer who underwent elective colorectal surgery.

Description of multimodal prehabilitationprogram	Description of usual care
• Multimodal prehabilitation consisted of case management of a specialized oncology nurse and anemia treatment. • In addition, patients were strongly advised to reduce intoxications (smoking cessation and reduction of alcohol intake). • During intake with the physical therapist, a personalized exercise program was made for each participant. • Each patient received tailored nutritional advice from a dietician. The exercise program designed by the physical therapist contained two components: 1) three times a week, for at least 3 weeks, a 60 min high-intensity training in the hospital supervised by a physical therapist; 2) four times a week for at least 60 min, a non-supervised low-intensity endurance training at home (e.g., walking or biking). • During the intake with a dietician, patients received tailored nutritional advice to achieve a total protein intake of 1.9 g per kg of lean body mass per day. Patients were also advised to take an additional 0.4 g per kg protein, within 1 h before high-intensity training and daily before bedtime. If necessary, protein shakes were prescribed to achieve this intake. • During prehabilitation, patients were followed by a dietician with a final consultation at the end of the program.	• Anemia treatment as indicated (using intravenous iron medication or blood transfusion per protocol) • A 30-minute preoperative assessment with the physical therapist for breathing exercises • A preoperative calculation of the nutritional assessment score (SNAQ). In case the SNAQ-score ≥3, patients were referred for a consultation with a dietician. • Patients were accompanied from diagnosis to the end of the treatment trajectory (including both surgery and chemotherapy) by a specialized oncology nurse who provided detailed information about the diagnosis and treatment process, as well as psychological support. • On indication, a psychologist was consulted

Description of multimodal prehabilitationprogram

Description of usual care

• Multimodal prehabilitation consisted of case management of a specialized oncology nurse and anemia treatment.
• In addition, patients were strongly advised to reduce intoxications (smoking cessation and reduction of alcohol intake).
• During intake with the physical therapist, a personalized exercise program was made for each participant.
• Each patient received tailored nutritional advice from a dietician. The exercise program designed by the physical therapist contained two components: 1) three times a week, for at least 3 weeks, a 60 min high-intensity training in the hospital supervised by a physical therapist; 2) four times a week for at least 60 min, a non-supervised low-intensity endurance training at home (e.g., walking or biking).
• During the intake with a dietician, patients received tailored nutritional advice to achieve a total protein intake of 1.9 g per kg of lean body mass per day. Patients were also advised to take an additional 0.4 g per kg protein, within 1 h before high-intensity training and daily before bedtime. If necessary, protein shakes were prescribed to achieve this intake.
• During prehabilitation, patients were followed by a dietician with a final consultation at the end of the program.

• Anemia treatment as indicated (using intravenous iron medication or blood transfusion per protocol)
• A 30-minute preoperative assessment with the physical therapist for breathing exercises
• A preoperative calculation of the nutritional assessment score (SNAQ). In case the SNAQ-score ≥3, patients were referred for a consultation with a dietician.
• Patients were accompanied from diagnosis to the end of the treatment trajectory (including both surgery and chemotherapy) by a specialized oncology nurse who provided detailed information about the diagnosis and treatment process, as well as psychological support.
• On indication, a psychologist was consulted