Journal Article

The CanMoRe trial – evaluating the effects of an exercise intervention after robotic-assisted radical cystectomy for urinary bladder cancer: the study protocol of a randomised controlled trial

Porserud, Andrea, Rydwik, Elisabeth, Henningsohn, Lars, Karlsson, Patrik, Nygren-Bonnier, Malin, Hagströmer, Maria, Aly, Markus

2020

Overview

Background Patients who have undergone radical cystectomy for urinary bladder cancer are not sufficiently physically active and therefore may suffer complications leading to readmissions. A physical rehabilitation programme early postoperatively might prevent or at least alleviate these potential complications and improve physical function. The main aim of the CanMoRe trial is to evaluate the impact of a standardised and individually adapted exercise intervention in primary health care to improve physical function (primary outcome) and habitual physical activity, health-related quality of life, fatigue, psychological wellbeing and readmissions due to complications in patients undergoing robotic-assisted radical cystectomy for urinary bladder cancer. Methods In total, 120 patients will be included and assigned to either intervention or control arm of the study. All patients will receive preoperative information on the importance of early mobilisation and during the hospital stay they will follow a standard protocol for enhanced mobilisation. The intervention group will be given a referral to a physiotherapist in primary health care close to their home. Within the third week after discharge, the intervention group will begin 12 weeks of biweekly exercise. The exercise programme includes aerobic and strengthening exercises. The control group will receive oral and written information about a home-based exercise programme. Physical function will serve as the primary outcome and will be measured using the Six-minute walk test. Secondary outcomes are gait speed, handgrip strength, leg strength, habitual physical activity, health-related quality of life, fatigue, psychological wellbeing and readmissions due to complications. The measurements will be conducted at discharge (i.e. baseline), post-intervention and 1 year after surgery. To evaluate the effects of the intervention mixed or linear regression models according to the intention to treat procedure will be used. Discussion This proposed randomised controlled trial has the potential to provide new knowledge within rehabilitation after radical cystectomy for urinary bladder cancer. The programme should be easy to apply to other patient groups undergoing abdominal surgery for cancer and has the potential to change the health care chain for these patients. Trial registration ClinicalTrials.gov. Clinical trial registration number NCT03998579 . First posted June 26, 2019.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Abdomen / Abdominal surgery / Adolescent / Adult / Aged / Analysis / Behaviour / Biomedical and Life Sciences / Biomedicine / Bladder cancer / Bladder neoplasm / Cancer / cancer burden and supportive therapy / Cancer Research / Child / Clinical trials / Complications / Cystectomy - adverse effects / Cystectomy - methods / Cystectomy - rehabilitation / Exercise / Exercise therapy / Exercise Therapy - methods / Fatigue / Female / Gait / Goal setting / Health care policy / Health care reform / Health Promotion and Disease Prevention / Humans / Intervention / Medical care quality / Medical records / Medicine/Public Health / Middle Aged / Oncology / Patient Readmission - statistics & numerical data / Patients / Physical activity / Physical fitness / Physical training / Postoperative Complications - epidemiology / Postoperative Complications - etiology / Postoperative Complications - prevention & control / Primary health care / Quality of Life / Randomized Controlled Trials as Topic / Regression analysis / Rehabilitation / Robotic surgery / Robotic Surgical Procedures - adverse effects / Robotic Surgical Procedures - rehabilitation / Study Protocol / Surgery / Surgical Oncology / Survivorship / Sweden / Taxonomy / Treatment Outcome / Urinary bladder / Urinary Bladder - pathology / Urinary Bladder - surgery / Urinary Bladder Neoplasms - complications / Urinary Bladder Neoplasms - surgery / Young Adult