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Objective To evaluate the effectiveness of multimodal prehabilitation among patients with esophageal neoplasm through meta-analysis. Methods Randomized controlled trials (RCTs) reporting the effectiveness of multimodal prehabilitation in patients with esophageal neoplasm were searched from PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, Chongqing VIP and CBM databases from the inception to October 1, 2023. Meta-analysis was performed by RevMan 5.4 software after quality evaluation. Results Ten RCTs consisting of 930 patients were included in this meta-analysis. The meta-analysis results showed that compared with conventional nursing, multimodal prehabilitation could lower the incidence of postoperative complications (relative risk (RR)=0.62, 95%CI 0.47-0.82), and shorten the length of hospital stay (mean difference (MD) = - 6.15d 95%CI -7.87--4.43 d), reduce hospital costs (MD=CNY-17 800, 95%CI-27 600--8 100), prolong 6-minute walking distance ( MD = 93.35m . 95%CI 36.19- 150.51 m) and increase serum albumin levels MD = 6.18g / L, 95%CI 4.08-8.28 g/L) and IgG levels (standardized mean difference (SMD) = 1.21 95%CI 1.01-1.42), respectively. Conclusions Multimodal prehabilitation can accelerate postoperative recovery, decrease the incidence of postoperative complications, improve partial exercise, nutritional and immunological indexes, shorten the length of hospital stay and reduce hospitalization costs. [ABSTRACT FROM AUTHOR]

Autonomic nerve dysfunction is a common non-motor symptom of Parkinson's disease (PD). It has a high incidence and involves multiple organ system disorders with various manifestations, seriously affecting the quality of life. Autonomic nerve dysfunction can be a major symptom of advanced PD and a major cause of disability. Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for advanced PD, and its improvement of motor symptoms in PD patients has been widely recognized. However, the effect of STN - DBS on the symptoms of autonomic nerve dysfunction in PD patients is still unclear. Here, the efficacy of STN - DBS on PD autonomic nerve dysfunction is briefly reviewed. Therefore, we should pay more attention to the symptoms of autonomic nerve dysfunction in PD patients, and conduct preoperative evaluation of DBS in PD patients, so as to comprehensively consider the postoperative efficacy, target selection, stimulus parameter setting, drug adjustment, develop an individualized treatment plan. [ABSTRACT FROM AUTHOR]

Objective·To systematically evaluate the effect of prehabilitation on outcomes in patients undergoing elective gastrointestinal surgery.Methods·PubMed, EMbase, Cochrane Library, Web of Science, CINAHL, Chinese BioMedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang and VIP Database were searched systematically from the establishment of each database to January 31, 2022. The literatures were screened, and evaluated according to the preset inclusion and exclusion criteria. The literature quality was evaluated and the data were extracted. Meta-analysis was performed on randomized controlled trials by using RevMan 5.4. The main observation indexes were the postoperative complication rate and the incidence of surgical site infection. The secondary indexes were hospitalization days, 6-minute walk test (6MWT), Hospital Anxiety and Depression Scale (HADS) score, mortality and compliance of prerehabilitation execution.Results·Sixteen articles were included, including 15 articles in English and 1 article in Chinese, with a total of 1 616 patients. The overall quality of the included researches was good. The meta-analysis results showed that compared with the control group, the incidences of postoperative complications and surgical site infection were reduced [(odds ratio, OR)=0.57, 95% (confidence interval, CI) 0.35‒0.94, P=0.030; OR=0.64, 95%CI 0.46‒0.90, P=0.009]; the length of hospital stay was shortened [mean difference (MD)=-2.45, 95%CI -3.17 ‒ -1.73, P=0.000] in the experimental group after the implementation of prehabilitation. There was no significant difference in preoperative 6MWT level between the two groups. Compared with the baseline, the change of 6MWT level before operation of the experimental group was bigger than that of the control group (MD=24.19, 95%CI 3.77‒44.60, P=0.020). There were no significant differences in the preoperative HADS score and the postoperative mortality between the two groups.Conclusion·Prehabilitation can reduce the incidence of postoperative complications, especially surgical site infection, in patients undergoing elective gastrointestinal surgery, thus shortening the length of hospital stay and promoting the recovery of patients.

Objective: To investigate the characteristics of preoperative functional exercise ability, muscle strength, anxiety, depression and health-related quality of life (QOL) in patients with esophageal cancer, and to evaluate the effect of radical resection of esophageal cancer on these parameters. Methods: We retrospectively analyzed 36 patients with newly diagnosed resectable esophageal cancer who underwent esophagectomy and postoperative rehabilitation from January to December 2019. The 6-min walking distance (6MWD), knee extensor strength, grip strength, Hospital Anxiety and Depression Scale (HADS) and Chronic Obstructive Pulmonary Disease (COPD) Assessment Scale (CAT) tests were performed before operation and 2 weeks after operation. Pulmonary function tests were performed preoperatively and a general health assessment was performed on the component of the MOS 36-item Health Questionnaire (SF-36). Results: The mean age of the patients was 66.1±9.2 years old. The patients were mainly male (75.0%), had a high smoking history (80.6%), and squamous cell carcinoma (94.4%). 15 cases of COPD. Clinical stage: 11 cases of stage 0-I, 6 cases of stage II, 15 cases of stage III, and 4 cases of stage IV. 29 routine laparotomy. The components of the SF-36 score were significantly correlated with the CAT and HADS scores, and the physical condition of COPD patients was significantly worse than that of non-COPD patients (P<0.05). Comparing the preoperative and postoperative values, it was found that 6MWD, grip strength, and isometric knee extensor muscle strength were significantly reduced after operation, and the CAT score was significantly increased (P<0.05), while the HADS score was not significantly increased (P>0.05). In multiple regression analysis, the postoperative 6MWD decrease was significantly associated with the preoperative SF-36 physiological component summary. Conclusion: From the perspective of minimally invasive surgery and perioperative management, it is necessary to further improve perioperative rehabilitation. At two weeks postoperatively, esophagectomy is detrimental to health-related QOL and physical fitness, and perioperative rehabilitation strategies need to be established to improve postoperative outcomes [ABSTRACT FROM AUTHOR]

Prehabilitation is the important starting part of enhanced recovery after surgery (ERAS). Multimodal prehabilitation management before thoracic surgery can increase the perioperative functional capacity of patients and help to improve the prognosis, which has been widely recognized. However, there are no guide- lines or standards of specific contents and implementation process of thoracic prehabilitation, causing some confusion in clinical practice. Expert Consensus on Prehabilitation Management for Enhanced Recovery in Patients undergoing Thoracic Surgery (2022) helps to provide a feasible guideline for clinical prehabilitaion practice, which was based on evidence-based medicine and experts' discussion to reach a preliminary consensus on five aspects of prehabilitation in thoracic surgery, including the indication, recommended duration, comprehensive evaluation before prehabilitation, specific practice contents, and management process.

BACKGROUND: Femoroacetabular impingement is a common cause of hip pain in adolescents. With the development of rehabilitation medicine, rehabilitation therapy has become one of the important methods to treat femoroacetabular impingement. OBJECTIVE: To provide new ideas and clues for further research and treatment of the disease by summarizing the latest achievements in the rehabilitation treatment of femoroacetabular impingement. METHODS: We searched the articles from December 2010 to October 2020 in PubMed, Cochrane, Web of Science, EMbase, CNKI, WanFang, VIP, SinoMed databases with the key words of “femoroacetabular impingement, femoroacetabular impingement syndrome, femoro-acetabular impingement” AND “rehabilitation, physiotherapy” AND “preoperative and postoperative rehabilitation of femoroacetabular impingement syndrome” in Chinese and English, respectively. Repetitive literatures and those that were not closely related to the purpose of this study were eliminated, and finally 61 articles were included for review. RESULTS AND CONCLUSION: Femoroacetabular impingement has pathological changes such as decreased muscle strength around the hip joint, decreased proprioception, changed activation pattern and coordination of deep muscles around the hip joint, and decreased mobility of the lower back and pelvis. The rehabilitation treatment of femoroacetabular impingement mainly focuses on muscle strength training around the hip joint, nerve-muscle training, core muscle strength training, preoperative and postoperative rehabilitation of hip arthroscopy, traditional Chinese medicine rehabilitation therapy, physical factor therapy and injection therapy. For patients with femoroacetabular impingement, muscle strength training around the hip joint can effectively reduce hip pain, increase range of motion and improve joint stability. Neuromuscular training can increase local muscle strength of the hip joint, improve proprioceptive sensation of the hip joint, and improve deep muscle synergy. Core muscle strength training can stabilize the lumbar vertebra and pelvis, reduce compensatory movement of the lumbar vertebra and pelvis, and enhance the effect of muscle strength training around the hip joint. Preoperative and postoperative rehabilitation training of hip arthroscopy can alleviate postoperative pain, improve patient’s function, and improve the therapeutic effect of hip arthroscopy. Traditional rehabilitation therapy and physical factor therapy can effectively eliminate joint inflammation and swelling and alleviate joint pain. Intraarticular injection of corticosteroids and sodium hyaluronate can effectively reduce hip pain and improve hip function in patients with femoroacetabular impingement. [ABSTRACT FROM AUTHOR]

Objective: To investigate the influencing factors of adherence to exercise prehabilitation in older patients with colorectal cancer., Methods: Based on the capacity, opportunity, and motivation of behavior change (COM-B) model, 12 older colorectal tumors patients undergoing elective surgeries at a tertiary-care hospital in Shanghai between August 2022 and December 2022 were enrolled for the study through purposive sampling. The respondents were involved in semi-structured interviews. Directed content analysis of their data was conducted to extract themes., Results: A total of 3 themes and 8 sub-themes were deduced from the analysis, including capacity (physical ability to tolerate exercise intensity and psychological experience of worrying about exercise risks), opportunity (adequate information support and professional guidance and simple and feasible exercise prescriptions and prehabilitation conditions), motivation (the intrinsic drive to identify with the prehabilitation values, the positive drive of inherent exercise habits, the continuous drive of exercise benefits, and the dual inspiration of team spirit and family support). These themes and subthemes were identified as influencing factors of adherence to exercise prehabilitation in older patients with colorectal cancer., Conclusion: Prehabilitation in older patients with colorectal cancer is influenced by multiple factors. Healthcare professionals should enhance education, develop individualized prehabilitation programs, and improve the diversified social support system to enhance patients' adherence to prehabilitation exercise and maximize the benefits of prehabilitation., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Gastrointestinal cancer and related treatments (surgery and chemoradiotherapy) are associated with declined functional status (FS) that has impact on quality of life, clinical outcome and continuum of care. Psychological distress drives an impressive burden of physiological and psychiatric conditions in oncologic care. Cancer patients often experience anxiety, depression, low self-esteem and fears of recurrence and death. Cancer prehabilitation is a process from cancer diagnosis to the beginning of treatment, which includes psychological, physical and nutritional assessments for a baseline functional level, identification of comorbidity, and targeted interventions that improve patient's health and functional capacity to reduce the incidence and the severity of current and future impairments with cancer, chemoradiotherapy and surgery. Multimodal prehabilitation program encompasses a series of planned, structured, repeatable and purposive interventions including comprehensive physical exercise, nutritional therapy, and relieving anxiety and depression, which integrates into best perioperative management ERAS pathway and aims at using the preoperative period to prevent or attenuate the surgery-related functional decline, to cope with surgical stress and to improve the consequences. However, a number of questions remain in regards to prehabilitation in gastrointestinal cancer surgery, which consists of the optimal makeup of training programs, the timing and approach of the intervention, how to improve compliance, how to measure functional capacity, and how to make cost-effective analysis. Therefore, more high-level evidence-based studies are expected to evaluate the value of implementation of prehabilitation into standard practice.