Postoperative Physical Training following Colorectal Surgery: A Randomised, Placebo-Controlled Study

Abstract

Background and Aims: Major surgery is often followed by fatigue and reduced physical function. We wished to study if postoperative physical training reduced fatigue and improved physical function. Material and Methods: Randomised, placebo-controlled, single-blinded study. Participants were unselected patients ≥ 60 years undergoing elective colorectal surgery without disseminated cancer or inflammatory bowel disease. Group A trained muscular strength and work capacity. Group B performed relaxation exercises and received hot wrappings and massage. Main outcome measures were: fatigue (visual analogue scale), muscular strength, walking speed, physical performance test, and physical function questions (SF-36). Results: Preoperatively the two groups were similar except that A was more fatigued than B. By postoperative day seven fatigue had increased compared to preoperatively, more in B than A, but by day 30 and 90 there were no significant differences between groups. All indices of physical function decreased postoperative day seven and were at the preoperative level day 90 with no significant differences between groups in change in function. Day seven the change in knee extension strength tended to be lower in B than A but by day 30 changes were similar in both groups. Conclusion: Postoperative training did not improve physical function, but reduced fatigue in hospital.