Prehabilitation for patients undergoing neoadjuvant treatment: results of a single-center pilot study using an integrative medicine day clinic.
Oncological prehabilitation aims to strengthen cancer patients physically and mentally before treatment, yet it is not standard care. The Prehabilitation through an Integrative Medicine Day Clinic (PRIME-DC) study examined the feasibility of a multimodal program during neoadjuvant therapy prior to surgery.
In this single-arm, mono-center interventional feasibility trial, patients attended a closed-group program once weekly for eight weeks (6.5-hour sessions) scheduled across the neoadjuvant treatment period. The curriculum integrated physical exercise, nutritional and naturopathic counseling, and Mind-Body Medicine practices. The primary outcome was program adherence, defined by attendance rate. Secondary outcomes included patient-reported measures of quality of life, anxiety, depression, fatigue, sleep, mindfulness, and physical fitness tests assessed at baseline and post-intervention. Patient satisfaction were evaluated at program completion.
Twenty-three of the 41 patients who were assessed for eligibility were enrolled, with an adherence rate of 69%. An exploratory within-group improvement in the 1-minute sit-to-stand test was observed from baseline to post-intervention (V1: 26.00 (22.00/34.00), V10a: 27.00 (24.99/34.00), 95% CI = 1.000 - 6.000, p = 0.02, r = 0.66), while other functional and patient-reported outcomes showed no statistically detectable within-group changes (p > 0.05). No study-related adverse events occurred. Patient satisfaction was assessed using a 17-item Likert scale (0-4). Overall, patients reported high levels of satisfaction (range: 0.00 - 1.88).
This pilot feasibility study provides preliminary evidence that participation in an integrative prehabilitation day-clinic program may be associated with the preservation of physical and mental health during neoadjuvant treatment. The findings indicate good feasibility and acceptability, providing a strong rationale for further investigation in larger, controlled trials.
https://drks.de/search/de/trial/DRKS00028126, identifier DRKS00028126.
In this single-arm, mono-center interventional feasibility trial, patients attended a closed-group program once weekly for eight weeks (6.5-hour sessions) scheduled across the neoadjuvant treatment period. The curriculum integrated physical exercise, nutritional and naturopathic counseling, and Mind-Body Medicine practices. The primary outcome was program adherence, defined by attendance rate. Secondary outcomes included patient-reported measures of quality of life, anxiety, depression, fatigue, sleep, mindfulness, and physical fitness tests assessed at baseline and post-intervention. Patient satisfaction were evaluated at program completion.
Twenty-three of the 41 patients who were assessed for eligibility were enrolled, with an adherence rate of 69%. An exploratory within-group improvement in the 1-minute sit-to-stand test was observed from baseline to post-intervention (V1: 26.00 (22.00/34.00), V10a: 27.00 (24.99/34.00), 95% CI = 1.000 - 6.000, p = 0.02, r = 0.66), while other functional and patient-reported outcomes showed no statistically detectable within-group changes (p > 0.05). No study-related adverse events occurred. Patient satisfaction was assessed using a 17-item Likert scale (0-4). Overall, patients reported high levels of satisfaction (range: 0.00 - 1.88).
This pilot feasibility study provides preliminary evidence that participation in an integrative prehabilitation day-clinic program may be associated with the preservation of physical and mental health during neoadjuvant treatment. The findings indicate good feasibility and acceptability, providing a strong rationale for further investigation in larger, controlled trials.
https://drks.de/search/de/trial/DRKS00028126, identifier DRKS00028126.
Authors
Klaus-Karwisch Klaus-Karwisch, Otto Otto, Werthmann Werthmann, Lederer Lederer, Mihaljevic Mihaljevic, Treiber Treiber, Cihlar Cihlar, Leins Leins, Mayer Mayer, Kramer Kramer
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