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The use of plain radiography in diagnosing osteoarthritis: A systematic review and time trend analysis

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BACKGROUND: Prehabilitation is thought to reduce post-operative respiratory complications by optimising fitness before surgery. This prospective, single-centre study aimed to establish the effect of pre-operative exercise on cardiorespiratory fitness in oesophageal cancer patients and characterise the effect of adherence and weekly physical activity on response to prehabilitation. METHODS: Patients received a personalised, home-based pre-operative exercise programme and self-reported their adherence each week. Cardiorespiratory fitness (pVO2max and O2 pulse) was assessed at diagnosis, following completion of neoadjuvant chemotherapy (NAC) and immediately before surgery. Study outcomes included changes in fitness and post-operative pneumonia. RESULTS: Sixty-seven patients with oesophageal cancer underwent prehabilitation followed by surgery between January 2016 and December 2018. Fitness was preserved during NAC and then increased prior to surgery (pV02max ??=?+2.6 ml min-1, 95% CI 1.2-4.0 p?=?0.001; O2 pulse ??=?+1.4 ml beat-1 95% CI 0.5-2.3 p?=?0.001). Patients with higher baseline fitness completed more physical activity. Regression analyses found adherence was associated with improvement in fitness immediately before surgery (p?=?0.048), and the amount of physical activity completed was associated with the risk of post-operative pneumonia (p?=?0.035). CONCLUSION: Pre-operative exercise can maintain cardiorespiratory fitness during NAC and facilitate an increase in fitness before surgery. Greater exercise volumes were associated with a lower risk of post-operative pneumonia, highlighting the importance progressing exercise programmes throughout prehabilitation. Patients with high baseline fitness completed more physical activity and may require less supervision to reach their exercise goals. Further research is needed to explore stratified approaches to prehabilitation.

Journal Article Type Article
Acceptance Date Nov 17, 2022
Online Publication Date Nov 25, 2022
Publication Date Apr 1, 2021
Publicly Available Date May 30, 2023
Journal Musculoskeletal Care
Print ISSN 1478-2189
Publisher Wiley
Volume 21
Issue 2
Pages 462-477
Keywords Nursing (miscellaneous), Rehabilitation, Physical Therapy, Sports Therapy and Rehabilitation, Orthopedics and Sports Medicine, Chiropractics, Rheumatology
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