Table 2

Prehabilitation modalities

Author and yearPrehabilitation interventionStandard of care
Au et al.40Home-based moderate intensity aerobic and resistance exercises prescribed and demonstrated shortly after consenting to surgery.
Manual detailing exercise prescription with supporting behaviour change strategies.
Book on maintaining a healthy lifestyle after a prostate cancer diagnosis with no further exercise support.
Barnejee et al.41Two supervised training sessions per week in an exercise facility for 6 weeks. Fractionated high-intensity aerobic exercise (cycle ergometer).Patients in the control group were advised to carry on with their lifestyles in the ‘usual way’.
Barakat et al.59Instructions and timetable to join hospital-based exercise classes, 3 times a week, 1-hour duration, during the 6 preoperative weeks.Continued with their normal lifestyle, and avoid any additional, unsupervised exercises.
Berkel et al.43Three one-hour supervised sessions of physical therapy per week. High-intensity interval training on a cycle ergometer and resistance training.Nutrition counselling and advice on smoking cessation.
Boden et al.44One 30-minute session with a physiotherapist for education and prevention of PPC, breathing exercises, delivery of a booklet.Breathing exercise booklet.
Chakravartty et al.47800 kcal VLCD regimen for 4 weeks. VLCD contained 3 pints of semi-skimmed milk, equivalent to 1704 ml (total intake of 800 kcal, 82 g carbohydrate, 61 g protein and 30 g fat), multivitamin and mineral supplementation, plus minimum of 2 l of energy-free liquid.Continued with their usual diet.
Dunne et al.4812 interval exercise sessions delivered by a cycle ergometer (moderate and vigorous intensity).Patients were encouraged to follow clinical advice on exercise before surgery.
Fulop et al.56Information booklet, work diary, multimodal home-based exercise programme plus weekly in-hospital exercise sessions, deep breathing, incentive spirometry, nutritionist evaluation and oral nutritional supplementation, 60-minute session with a trained psychologist (techniques to reduce anxiety + lifestyle advice).Not reported.
Gloor et al.66Training twice a week with a qualified physiotherapist, and once supervised at home. Each session was 90 min (10 min warm up, 35 min endurance training (HIT), 35 min strength training, 10 min cool down).Continued with usual physical activities
Grat et al.49Probiotic capsules once/day until transplant (Lactococcus lactis PB411 (50.0%), Lactobacillus casei PB121 (25.0%), Lactobacillus acidophilus PB111 (12.5%) and Bifidobacterium bifidum PB211 (12.5%)).Daily placebo.
Hollis et al.50VLCD programme (+ 2 cups vegetable salad, 2 l non-energy-free fluids, one teaspoon of vegetable oil).Not reported.
Hoogeboom et al.6060 min of supervised exercise sessions at the outpatient clinic twice a week for 3–6 weeks preoperatively. Patients were encouraged to exercise at home.One group-based education session (early mobilization, surgery and anaesthesia, restricted movements, benefits of activity).
IJmker-Hemink et al.61Pre-cooked meals for 3 weeks: 6 protein-rich dishes per day (morning shake, 2 lunch dishes, snack, dinner and dessert for each day (avg energy 1553 kcal/day, avg protein 60.8 g/day)) + information leaflet describing personal protein requirements (1.2 g/kg body weight) and ‘protein-meter’ for protein intake.Usual care with habitual diet followed.
Karenovics et al.62Up to 3 weekly supervised high-intensity training sessions using a cycle ergometer. Advice on active mobilization and risk factor management.Not reported.
Karlsson et al.632–3 supervised sessions per week for 6 weeks. Inspiratory muscle training (30 breaths twice a day), high-intensity functional strength exercises. Difficulty was increased for progression. + Usual careOrdinary preoperative information and recommendation of 150 min per week of moderate physical intensity.
Liu et al.70Aerobic and resistance exercises, respiratory training, nutritional counselling with whey protein supplementation, psychological adjustments (basic mental relaxation skills), conventional guidance.Not reported.
Minnella et al.67Home-based programme (aerobic exercise and moderate continuous training 3 days per week after one demonstration session with a kinesiologist). Dietary advice + whey protein supplement (daily protein intake of 1.2 to 1.5 g/kg).No specific intervention before surgery.
Minnella et al.68Same as Minnella 2018 + relaxation and imaging techniques.No specific intervention before surgery.
Moug et al.518 weeks of graduated goals calculated from the baseline stepping count. Walking diary and use of a pedometer. Follow-up telephone calls. Support person (for example, spouse) to assist in their adherence to the programme.Maintain their normal level of physical activity.
Oosting et al.52Home-based exercise programme with patient-tailored functional activities and walking. Pedometer (goal = minimum 30 min per day) + 30 min supervised sessions twice a week for 3–6 weeks.Usual care: one session of instructions, a single group session supervised by a physical therapist 3 weeks before surgery.
Rolving et al.64Four 3-hour group sessions directed by a multidisciplinary team on interaction between cognition and pain perception, coping strategies, pacing principles, ergonomic directions, return to work, details about the surgical procedure.Standard preoperative information.
Santa Mina et al.54Pelvic floor muscle exercise and total body exercises. 60 min of unsupervised, home-based, moderate intensity exercise 3–4 days per week. (Exercise manual with online exercises.)Manual detailing a pelvic floor training regimen.
Sebio Garcia et al.55One hour supervised pulmonary prehabilitation programme 3–5 times per week. Moderate endurance (ergometer) and resistance training.Usual care—no exercise training.
Steffens et al.69Exercise sessions: 1 h individualized, hospital-based training session once a week for 2–6 weeks (aerobic and endurance, respiratory, muscle strength) + personalized home exercises + activity tracker (goal = 30 min walk/day).Nutritional counselling and advice on smoking cessation, reduction of alcohol intake. Instruction to maintain normal daily activities.
Tew et al.65Three hospital-based supervised exercise sessions on a cycle ergometer per week for the 4 consecutive weeks preceding their operation date.Usual care, which comprised evidence-based medical optimization.
Author and yearPrehabilitation interventionStandard of care
Au et al.40Home-based moderate intensity aerobic and resistance exercises prescribed and demonstrated shortly after consenting to surgery.
Manual detailing exercise prescription with supporting behaviour change strategies.
Book on maintaining a healthy lifestyle after a prostate cancer diagnosis with no further exercise support.
Barnejee et al.41Two supervised training sessions per week in an exercise facility for 6 weeks. Fractionated high-intensity aerobic exercise (cycle ergometer).Patients in the control group were advised to carry on with their lifestyles in the ‘usual way’.
Barakat et al.59Instructions and timetable to join hospital-based exercise classes, 3 times a week, 1-hour duration, during the 6 preoperative weeks.Continued with their normal lifestyle, and avoid any additional, unsupervised exercises.
Berkel et al.43Three one-hour supervised sessions of physical therapy per week. High-intensity interval training on a cycle ergometer and resistance training.Nutrition counselling and advice on smoking cessation.
Boden et al.44One 30-minute session with a physiotherapist for education and prevention of PPC, breathing exercises, delivery of a booklet.Breathing exercise booklet.
Chakravartty et al.47800 kcal VLCD regimen for 4 weeks. VLCD contained 3 pints of semi-skimmed milk, equivalent to 1704 ml (total intake of 800 kcal, 82 g carbohydrate, 61 g protein and 30 g fat), multivitamin and mineral supplementation, plus minimum of 2 l of energy-free liquid.Continued with their usual diet.
Dunne et al.4812 interval exercise sessions delivered by a cycle ergometer (moderate and vigorous intensity).Patients were encouraged to follow clinical advice on exercise before surgery.
Fulop et al.56Information booklet, work diary, multimodal home-based exercise programme plus weekly in-hospital exercise sessions, deep breathing, incentive spirometry, nutritionist evaluation and oral nutritional supplementation, 60-minute session with a trained psychologist (techniques to reduce anxiety + lifestyle advice).Not reported.
Gloor et al.66Training twice a week with a qualified physiotherapist, and once supervised at home. Each session was 90 min (10 min warm up, 35 min endurance training (HIT), 35 min strength training, 10 min cool down).Continued with usual physical activities
Grat et al.49Probiotic capsules once/day until transplant (Lactococcus lactis PB411 (50.0%), Lactobacillus casei PB121 (25.0%), Lactobacillus acidophilus PB111 (12.5%) and Bifidobacterium bifidum PB211 (12.5%)).Daily placebo.
Hollis et al.50VLCD programme (+ 2 cups vegetable salad, 2 l non-energy-free fluids, one teaspoon of vegetable oil).Not reported.
Hoogeboom et al.6060 min of supervised exercise sessions at the outpatient clinic twice a week for 3–6 weeks preoperatively. Patients were encouraged to exercise at home.One group-based education session (early mobilization, surgery and anaesthesia, restricted movements, benefits of activity).
IJmker-Hemink et al.61Pre-cooked meals for 3 weeks: 6 protein-rich dishes per day (morning shake, 2 lunch dishes, snack, dinner and dessert for each day (avg energy 1553 kcal/day, avg protein 60.8 g/day)) + information leaflet describing personal protein requirements (1.2 g/kg body weight) and ‘protein-meter’ for protein intake.Usual care with habitual diet followed.
Karenovics et al.62Up to 3 weekly supervised high-intensity training sessions using a cycle ergometer. Advice on active mobilization and risk factor management.Not reported.
Karlsson et al.632–3 supervised sessions per week for 6 weeks. Inspiratory muscle training (30 breaths twice a day), high-intensity functional strength exercises. Difficulty was increased for progression. + Usual careOrdinary preoperative information and recommendation of 150 min per week of moderate physical intensity.
Liu et al.70Aerobic and resistance exercises, respiratory training, nutritional counselling with whey protein supplementation, psychological adjustments (basic mental relaxation skills), conventional guidance.Not reported.
Minnella et al.67Home-based programme (aerobic exercise and moderate continuous training 3 days per week after one demonstration session with a kinesiologist). Dietary advice + whey protein supplement (daily protein intake of 1.2 to 1.5 g/kg).No specific intervention before surgery.
Minnella et al.68Same as Minnella 2018 + relaxation and imaging techniques.No specific intervention before surgery.
Moug et al.518 weeks of graduated goals calculated from the baseline stepping count. Walking diary and use of a pedometer. Follow-up telephone calls. Support person (for example, spouse) to assist in their adherence to the programme.Maintain their normal level of physical activity.
Oosting et al.52Home-based exercise programme with patient-tailored functional activities and walking. Pedometer (goal = minimum 30 min per day) + 30 min supervised sessions twice a week for 3–6 weeks.Usual care: one session of instructions, a single group session supervised by a physical therapist 3 weeks before surgery.
Rolving et al.64Four 3-hour group sessions directed by a multidisciplinary team on interaction between cognition and pain perception, coping strategies, pacing principles, ergonomic directions, return to work, details about the surgical procedure.Standard preoperative information.
Santa Mina et al.54Pelvic floor muscle exercise and total body exercises. 60 min of unsupervised, home-based, moderate intensity exercise 3–4 days per week. (Exercise manual with online exercises.)Manual detailing a pelvic floor training regimen.
Sebio Garcia et al.55One hour supervised pulmonary prehabilitation programme 3–5 times per week. Moderate endurance (ergometer) and resistance training.Usual care—no exercise training.
Steffens et al.69Exercise sessions: 1 h individualized, hospital-based training session once a week for 2–6 weeks (aerobic and endurance, respiratory, muscle strength) + personalized home exercises + activity tracker (goal = 30 min walk/day).Nutritional counselling and advice on smoking cessation, reduction of alcohol intake. Instruction to maintain normal daily activities.
Tew et al.65Three hospital-based supervised exercise sessions on a cycle ergometer per week for the 4 consecutive weeks preceding their operation date.Usual care, which comprised evidence-based medical optimization.

PPC, postoperative pulmonary complication; VLCD, very low-calorie diet.

Table 2

Prehabilitation modalities

Author and yearPrehabilitation interventionStandard of care
Au et al.40Home-based moderate intensity aerobic and resistance exercises prescribed and demonstrated shortly after consenting to surgery.
Manual detailing exercise prescription with supporting behaviour change strategies.
Book on maintaining a healthy lifestyle after a prostate cancer diagnosis with no further exercise support.
Barnejee et al.41Two supervised training sessions per week in an exercise facility for 6 weeks. Fractionated high-intensity aerobic exercise (cycle ergometer).Patients in the control group were advised to carry on with their lifestyles in the ‘usual way’.
Barakat et al.59Instructions and timetable to join hospital-based exercise classes, 3 times a week, 1-hour duration, during the 6 preoperative weeks.Continued with their normal lifestyle, and avoid any additional, unsupervised exercises.
Berkel et al.43Three one-hour supervised sessions of physical therapy per week. High-intensity interval training on a cycle ergometer and resistance training.Nutrition counselling and advice on smoking cessation.
Boden et al.44One 30-minute session with a physiotherapist for education and prevention of PPC, breathing exercises, delivery of a booklet.Breathing exercise booklet.
Chakravartty et al.47800 kcal VLCD regimen for 4 weeks. VLCD contained 3 pints of semi-skimmed milk, equivalent to 1704 ml (total intake of 800 kcal, 82 g carbohydrate, 61 g protein and 30 g fat), multivitamin and mineral supplementation, plus minimum of 2 l of energy-free liquid.Continued with their usual diet.
Dunne et al.4812 interval exercise sessions delivered by a cycle ergometer (moderate and vigorous intensity).Patients were encouraged to follow clinical advice on exercise before surgery.
Fulop et al.56Information booklet, work diary, multimodal home-based exercise programme plus weekly in-hospital exercise sessions, deep breathing, incentive spirometry, nutritionist evaluation and oral nutritional supplementation, 60-minute session with a trained psychologist (techniques to reduce anxiety + lifestyle advice).Not reported.
Gloor et al.66Training twice a week with a qualified physiotherapist, and once supervised at home. Each session was 90 min (10 min warm up, 35 min endurance training (HIT), 35 min strength training, 10 min cool down).Continued with usual physical activities
Grat et al.49Probiotic capsules once/day until transplant (Lactococcus lactis PB411 (50.0%), Lactobacillus casei PB121 (25.0%), Lactobacillus acidophilus PB111 (12.5%) and Bifidobacterium bifidum PB211 (12.5%)).Daily placebo.
Hollis et al.50VLCD programme (+ 2 cups vegetable salad, 2 l non-energy-free fluids, one teaspoon of vegetable oil).Not reported.
Hoogeboom et al.6060 min of supervised exercise sessions at the outpatient clinic twice a week for 3–6 weeks preoperatively. Patients were encouraged to exercise at home.One group-based education session (early mobilization, surgery and anaesthesia, restricted movements, benefits of activity).
IJmker-Hemink et al.61Pre-cooked meals for 3 weeks: 6 protein-rich dishes per day (morning shake, 2 lunch dishes, snack, dinner and dessert for each day (avg energy 1553 kcal/day, avg protein 60.8 g/day)) + information leaflet describing personal protein requirements (1.2 g/kg body weight) and ‘protein-meter’ for protein intake.Usual care with habitual diet followed.
Karenovics et al.62Up to 3 weekly supervised high-intensity training sessions using a cycle ergometer. Advice on active mobilization and risk factor management.Not reported.
Karlsson et al.632–3 supervised sessions per week for 6 weeks. Inspiratory muscle training (30 breaths twice a day), high-intensity functional strength exercises. Difficulty was increased for progression. + Usual careOrdinary preoperative information and recommendation of 150 min per week of moderate physical intensity.
Liu et al.70Aerobic and resistance exercises, respiratory training, nutritional counselling with whey protein supplementation, psychological adjustments (basic mental relaxation skills), conventional guidance.Not reported.
Minnella et al.67Home-based programme (aerobic exercise and moderate continuous training 3 days per week after one demonstration session with a kinesiologist). Dietary advice + whey protein supplement (daily protein intake of 1.2 to 1.5 g/kg).No specific intervention before surgery.
Minnella et al.68Same as Minnella 2018 + relaxation and imaging techniques.No specific intervention before surgery.
Moug et al.518 weeks of graduated goals calculated from the baseline stepping count. Walking diary and use of a pedometer. Follow-up telephone calls. Support person (for example, spouse) to assist in their adherence to the programme.Maintain their normal level of physical activity.
Oosting et al.52Home-based exercise programme with patient-tailored functional activities and walking. Pedometer (goal = minimum 30 min per day) + 30 min supervised sessions twice a week for 3–6 weeks.Usual care: one session of instructions, a single group session supervised by a physical therapist 3 weeks before surgery.
Rolving et al.64Four 3-hour group sessions directed by a multidisciplinary team on interaction between cognition and pain perception, coping strategies, pacing principles, ergonomic directions, return to work, details about the surgical procedure.Standard preoperative information.
Santa Mina et al.54Pelvic floor muscle exercise and total body exercises. 60 min of unsupervised, home-based, moderate intensity exercise 3–4 days per week. (Exercise manual with online exercises.)Manual detailing a pelvic floor training regimen.
Sebio Garcia et al.55One hour supervised pulmonary prehabilitation programme 3–5 times per week. Moderate endurance (ergometer) and resistance training.Usual care—no exercise training.
Steffens et al.69Exercise sessions: 1 h individualized, hospital-based training session once a week for 2–6 weeks (aerobic and endurance, respiratory, muscle strength) + personalized home exercises + activity tracker (goal = 30 min walk/day).Nutritional counselling and advice on smoking cessation, reduction of alcohol intake. Instruction to maintain normal daily activities.
Tew et al.65Three hospital-based supervised exercise sessions on a cycle ergometer per week for the 4 consecutive weeks preceding their operation date.Usual care, which comprised evidence-based medical optimization.
Author and yearPrehabilitation interventionStandard of care
Au et al.40Home-based moderate intensity aerobic and resistance exercises prescribed and demonstrated shortly after consenting to surgery.
Manual detailing exercise prescription with supporting behaviour change strategies.
Book on maintaining a healthy lifestyle after a prostate cancer diagnosis with no further exercise support.
Barnejee et al.41Two supervised training sessions per week in an exercise facility for 6 weeks. Fractionated high-intensity aerobic exercise (cycle ergometer).Patients in the control group were advised to carry on with their lifestyles in the ‘usual way’.
Barakat et al.59Instructions and timetable to join hospital-based exercise classes, 3 times a week, 1-hour duration, during the 6 preoperative weeks.Continued with their normal lifestyle, and avoid any additional, unsupervised exercises.
Berkel et al.43Three one-hour supervised sessions of physical therapy per week. High-intensity interval training on a cycle ergometer and resistance training.Nutrition counselling and advice on smoking cessation.
Boden et al.44One 30-minute session with a physiotherapist for education and prevention of PPC, breathing exercises, delivery of a booklet.Breathing exercise booklet.
Chakravartty et al.47800 kcal VLCD regimen for 4 weeks. VLCD contained 3 pints of semi-skimmed milk, equivalent to 1704 ml (total intake of 800 kcal, 82 g carbohydrate, 61 g protein and 30 g fat), multivitamin and mineral supplementation, plus minimum of 2 l of energy-free liquid.Continued with their usual diet.
Dunne et al.4812 interval exercise sessions delivered by a cycle ergometer (moderate and vigorous intensity).Patients were encouraged to follow clinical advice on exercise before surgery.
Fulop et al.56Information booklet, work diary, multimodal home-based exercise programme plus weekly in-hospital exercise sessions, deep breathing, incentive spirometry, nutritionist evaluation and oral nutritional supplementation, 60-minute session with a trained psychologist (techniques to reduce anxiety + lifestyle advice).Not reported.
Gloor et al.66Training twice a week with a qualified physiotherapist, and once supervised at home. Each session was 90 min (10 min warm up, 35 min endurance training (HIT), 35 min strength training, 10 min cool down).Continued with usual physical activities
Grat et al.49Probiotic capsules once/day until transplant (Lactococcus lactis PB411 (50.0%), Lactobacillus casei PB121 (25.0%), Lactobacillus acidophilus PB111 (12.5%) and Bifidobacterium bifidum PB211 (12.5%)).Daily placebo.
Hollis et al.50VLCD programme (+ 2 cups vegetable salad, 2 l non-energy-free fluids, one teaspoon of vegetable oil).Not reported.
Hoogeboom et al.6060 min of supervised exercise sessions at the outpatient clinic twice a week for 3–6 weeks preoperatively. Patients were encouraged to exercise at home.One group-based education session (early mobilization, surgery and anaesthesia, restricted movements, benefits of activity).
IJmker-Hemink et al.61Pre-cooked meals for 3 weeks: 6 protein-rich dishes per day (morning shake, 2 lunch dishes, snack, dinner and dessert for each day (avg energy 1553 kcal/day, avg protein 60.8 g/day)) + information leaflet describing personal protein requirements (1.2 g/kg body weight) and ‘protein-meter’ for protein intake.Usual care with habitual diet followed.
Karenovics et al.62Up to 3 weekly supervised high-intensity training sessions using a cycle ergometer. Advice on active mobilization and risk factor management.Not reported.
Karlsson et al.632–3 supervised sessions per week for 6 weeks. Inspiratory muscle training (30 breaths twice a day), high-intensity functional strength exercises. Difficulty was increased for progression. + Usual careOrdinary preoperative information and recommendation of 150 min per week of moderate physical intensity.
Liu et al.70Aerobic and resistance exercises, respiratory training, nutritional counselling with whey protein supplementation, psychological adjustments (basic mental relaxation skills), conventional guidance.Not reported.
Minnella et al.67Home-based programme (aerobic exercise and moderate continuous training 3 days per week after one demonstration session with a kinesiologist). Dietary advice + whey protein supplement (daily protein intake of 1.2 to 1.5 g/kg).No specific intervention before surgery.
Minnella et al.68Same as Minnella 2018 + relaxation and imaging techniques.No specific intervention before surgery.
Moug et al.518 weeks of graduated goals calculated from the baseline stepping count. Walking diary and use of a pedometer. Follow-up telephone calls. Support person (for example, spouse) to assist in their adherence to the programme.Maintain their normal level of physical activity.
Oosting et al.52Home-based exercise programme with patient-tailored functional activities and walking. Pedometer (goal = minimum 30 min per day) + 30 min supervised sessions twice a week for 3–6 weeks.Usual care: one session of instructions, a single group session supervised by a physical therapist 3 weeks before surgery.
Rolving et al.64Four 3-hour group sessions directed by a multidisciplinary team on interaction between cognition and pain perception, coping strategies, pacing principles, ergonomic directions, return to work, details about the surgical procedure.Standard preoperative information.
Santa Mina et al.54Pelvic floor muscle exercise and total body exercises. 60 min of unsupervised, home-based, moderate intensity exercise 3–4 days per week. (Exercise manual with online exercises.)Manual detailing a pelvic floor training regimen.
Sebio Garcia et al.55One hour supervised pulmonary prehabilitation programme 3–5 times per week. Moderate endurance (ergometer) and resistance training.Usual care—no exercise training.
Steffens et al.69Exercise sessions: 1 h individualized, hospital-based training session once a week for 2–6 weeks (aerobic and endurance, respiratory, muscle strength) + personalized home exercises + activity tracker (goal = 30 min walk/day).Nutritional counselling and advice on smoking cessation, reduction of alcohol intake. Instruction to maintain normal daily activities.
Tew et al.65Three hospital-based supervised exercise sessions on a cycle ergometer per week for the 4 consecutive weeks preceding their operation date.Usual care, which comprised evidence-based medical optimization.

PPC, postoperative pulmonary complication; VLCD, very low-calorie diet.

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