Physical Activity in Relation to Surgical Procedures

Physsurg - a Controlled Randomized Trial on the Effect of Physical Activity in Relation to Outcome After Surgery

This study will compare the outcome after surgery between a group of patients that receives instructions for prehabilitation training and one group that received standard treatment.

Study Overview

• Status: Completed
• Conditions: Colorectal Cancer; Surgery
• Intervention / Treatment: Other: Physical activity

Detailed Description

The aim of this study is to investigate whether a training program with intensified physical activity prior to and after a surgical procedure reduces the surgical-related postoperative recovery time, hospital stay, sick leave and complication rate.

A secondary aim is to investigate the effect of a training program with pre- and post- operative PA on the rate of resumption of QoL and normal physical function.

• Study Type: Interventional
• Enrollment (Actual): 761
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Sweden
  • Gothenburg, Sweden, 416 85
    • Sahlgrenska University Hospital/Östra
  • Skövde, Sweden
    • Dept. of Surgery, Skaraborgs Sjukhus

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Diagnosed colorectal cancer and a planned surgical procedure

Exclusion Criteria:

• HIPEC surgery, not able to give informed consent or understand the intervention

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Pre and postoperative exercise; The intervention is prehabilitation preoperatively and physical training postoperatively. During the hospital stay both groups will be treated in the same manner. Preoperative intervention: One half hour of exercise daily added to the existing daily exercise routine. The level of exercise should produce shortness of breath but the patient should be able to talk without much effort. Inspiratory muscle training. Thirty breaths x two twice daily. Postoperative intervention is mainly the same as preoperatively.	Other: Physical activity; The intervention will take place both pre- and postoperatively. During the hospital stay both groups will be treated in the same manner.
No Intervention: Control; Standard treatment with one exception, patients will fill in a physical activity diary

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Recovery measured as physical recovery measured in questionnaire	4-6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Psychological recovery measured in a questionnaire, patient reported	Recovery	4-6 weeks and 1 year post-operatively
Recovery measured as time back to work	Recovery	1 year
Complications according to Clavien-Dindo	Postoperative complications	within 90 days
QoL measured using SF-36	QoL according to SF-36	4-6 weeks and 1 year
QoL measured using EQ-5D	QoL according to EQ-5D	4-6 weeks and 1 year
QoL measured using a specifically developed instrument for this study	Health related QoL	4-6 weeks and 1 year
Mortality	Long term mortality	3 and 5 years
Re-admissions	Hospital re-admissions	1 year
Reoperations	Reoperations	1 year
Total time of hospital stay	Length of stay	1 year
IGF-1 and IGFBP-3	Lab values	4 weeks postopeartively
Postoperative pain measured with Brief Pain Inventory-Short form	Pain measured by BPI-S	4 weeks
Postoperative pain measured with Brief Pain Inventory-Short form	Pain measured by BPI-S	12 months
Health economic analysis	Health economic analysis modified according to results of primary outcome	4 weeks
Health economic analysis	Health economic analysis modified according to results of primary outcome	12 months

Collaborators and Investigators

• Sponsor: Sahlgrenska University Hospital
• Investigators: Principal Investigator: Eva Haglind, M.D., Ph.D., SSORG

Publications and helpful links

General Publications

• Molenaar CJ, van Rooijen SJ, Fokkenrood HJ, Roumen RM, Janssen L, Slooter GD. Prehabilitation versus no prehabilitation to improve functional capacity, reduce postoperative complications and improve quality of life in colorectal cancer surgery. Cochrane Database Syst Rev. 2022 May 19;5(5):CD013259. doi: 10.1002/14651858.CD013259.pub2.
• Onerup A, Li Y, Afshari K, Angenete E, de la Croix H, Ehrencrona C, Wedin A, Haglind E. Long-term results of a short-term home-based pre- and postoperative exercise intervention on physical recovery after colorectal cancer surgery (PHYSSURG-C): a randomized clinical trial. Colorectal Dis. 2024 Mar;26(3):545-553. doi: 10.1111/codi.16860. Epub 2024 Jan 15.
• Molenaar CJ, van Rooijen SJ, Fokkenrood HJ, Roumen RM, Janssen L, Slooter GD. Prehabilitation versus no prehabilitation to improve functional capacity, reduce postoperative complications and improve quality of life in colorectal cancer surgery. Cochrane Database Syst Rev. 2023 May 10;5(5):CD013259. doi: 10.1002/14651858.CD013259.pub3.
• Onerup A, Thorn SE, Angenete E, Bock D, Gryback Gillheimer E, Haglind E, Nilsson H. Effects of a home-based exercise program on the insulin-like growth factor axis in patients operated for colorectal cancer in Sweden: Results from the randomised controlled trial PHYSSURG-C. Growth Horm IGF Res. 2020 Apr;51:27-33. doi: 10.1016/j.ghir.2020.01.005. Epub 2020 Jan 28.
• Onerup A, Angenete E, Bock D, Borjesson M, Fagevik Olsen M, Gryback Gillheimer E, Skullman S, Thorn SE, Haglind E, Nilsson H. The effect of pre- and post-operative physical activity on recovery after colorectal cancer surgery (PHYSSURG-C): study protocol for a randomised controlled trial. Trials. 2017 May 8;18(1):212. doi: 10.1186/s13063-017-1949-9.

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2015
• Primary Completion (Actual): May 31, 2020
• Study Completion (Actual): December 31, 2025

Study Registration Dates

• First Submitted: November 17, 2014
• First Submitted That Met QC Criteria: November 20, 2014
• First Posted (Estimated): November 24, 2014

Study Record Updates

• Last Update Posted (Actual): April 27, 2026
• Last Update Submitted That Met QC Criteria: April 22, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Physical activity; Colorectal neoplasm
• Additional Relevant MeSH Terms: Neoplasms by Site; Neoplasms; Intestinal Diseases; Gastrointestinal Neoplasms; Digestive System Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Intestinal Neoplasms; Rectal Diseases; Colonic Diseases; Behavior; Colorectal Neoplasms; Motor Activity; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Exercise
• Other Study ID Numbers: Physsurg C - the RCT

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED