Supportive exercise programmes for accelerating recovery after major abdominal cancer surgery

INTERVENTION: Participants are randomly allocated to one of three groups. Control arm: Treatment as Usual (TAU) comprising the patient information leaflet only. No other information relating to peri‐operative exercise will be offered, consistent with current practice. Intervention arm 1 (Hospital‐Based Supervised exercise programme): Pre‐surgery, participants receive an initial 45 min exercise counselling incorporating behaviour modification techniques. Patients will be offered three sessions per week of aerobic interval exercise on a cycle ergometer over 3‐4 weeks prior to their procedure (aim is to achieve 12 sessions). In addition, patients will undertake twice weekly resistance exercise. Exercise programmes will be tailored to each patient, taking previous level of activity, mobility and any barriers to exercise into consideration. Until the end of the study (12 months post‐randomisation), patients will be encouraged to comply with current physical activity recommendations: 150 min of moderate intensity aerobic exercise per week (brisk walking / cycling) and two sessions of resistance exercise per week. They will also be sign posted to local exercise facilities and receive monthly supervised ‘booster’ exercise sessions. Intervention arm 2 (Supported Home‐Based exercise): Participants receive an initial 45 min exercise counselling incorporating behaviour modification techniques. Patients will then be encouraged to comply with current physical activity recommendations, which will form the basis of the home exercise programme: a minimum of 150 min of moderate intensity aerobic exercise per week (brisk walking / cycling) and two sessions of resistance exercise. Exercise programmes will be tailored to each patient, taking previous level of activity, mobility and any barriers to exercise into consideration. Patients will receive weekly 15 min telephone support from a Trial Physiotherapist to encourage compliance with the exercise programme. Until the end of the study (12 months CONDITION: Specialty: Cancer, Primary sub‐specialty: Colorectal; UKCRC code/ Disease: Cancer/ Malignant neoplasms of digestive organs ; Cancer ; Cancer/Malignant neoplasms of digestive organs PRIMARY OUTCOME: Health‐related quality of life is measured using the Study Short‐Form Health Questionnaire (SF‐36) at baseline and 12 months post‐randomisation. SECONDARY OUTCOME: 1. Post‐operative morbidity is measured 30 days post‐surgery; 2. Cardiopulmonary fitness ; 3. Grip strength; 4. Length of hospital stay is recorded at discharge following operation; 5. Fitness for discharge is recorded at discharge following operation; 6. Re‐admission rate is determined 90 days post‐surgery; 7. Post‐operative mortality is measured 90 days post‐surgery; 8. Physical activity behaviour is measured 6 and 12 months; 9. Psychological health statusis measured 6 and 12 months INCLUSION CRITERIA: 1. Male and female participants = 18 years old 2. Awaiting a curative elective colorectal resection for cancer 3. American Society of Anaesthesiologists physical status I‐III (ASA, 2014) 4. Able and willing to provide informed consent 5. Understand verbal and written instructions in English 6. Patients who are already participating (or have participated) in other trials may be eligible, but this must be agreed in advance by the relevant trial teams