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Table 3 Summary of findings table for the comparison: combined training vs rehabilitation/usual care

From: Prehabilitation programs for individuals with cancer: a systematic review of randomized-controlled trials

Prehabilitation programs for individuals with cancer

Population: adults with lung, esophageal, prostate, and colorectal cancer

Intervention: combined training

Comparison: rehabilitation, usual care

Setting: Mixed (home and clinic / hospital)

Outcomes

Relative effect (95% CI)

Anticipated absolute effecta

(95% CI)

Nº of

participants

(studies)

Certainty

of the evidence

(GRADE)

  

Assumed risk with control

Assumed risk with intervention

  

HRQoL (physical component)b before surgery

MD -2.46 (-7.88 to 2.95)

49 to 59 points

Mean HRQoL in intervention was 2.46 lower (7.9 lower to 2.9 higher)

174 (3 RCTs)

⨁◯◯◯

VERY LOW h,i

HRQoL (mental component)b before surgery

MD -2.82 (-8.60 to 2.95)

48 to 70 points

Mean HRQoL in intervention was 2.82 lower (8.6 lower to 2.9 higher)

174 (3 RCTs)

⨁◯◯◯

VERY LOW h,i

HRQoL (overall score)b before surgery

Not estimable

-

-

61 (1 RCT)

⨁◯◯◯

VERY LOW j,k

HRQoL (overall score)b long term (up to 26 weeks)

Not estimable

-

-

157 (3 RCTs)

⨁◯◯◯

VERY LOW j,l

Muscular strength: (before surgery up to 26 weeks)c

Not estimable

-

-

162 (4 RCTs)

⨁◯◯◯

VERY LOW h,i

Postoperative complications: Grade 1

(4 weeks)d

RR 1.06

(0.88 to 1.29)

6 per 100

6 per 100

(5 fewer to 8 more)

300 (4 RCTs)

⨁◯◯◯

VERY LOW j,k

Postoperative complications: Grade 2 (4 weeks)d

RR 0.76

(0.48 to 1.18)

1 per 10

1 per 10

(1 fewer to 2 more)

300 (4 RCTs)

⨁◯◯◯

VERY LOW j,k

Postoperative complications: Grade 3 (4 weeks)d

RR 2.78 (0.76 to 10.23)

1 per 10

3 per 10

(1 fewer to 5 more)

300 (4 RCTs)

⨁◯◯◯

VERY LOW j,k

Postoperative complications: Grade 4 (4 weeks)d

RR 1.02 (0.27 to 3.85)

1 per 10

1 per 10

(1 fewer to 4 more)

164 (2 RCTs)

⨁◯◯◯

VERY LOW j,k

Average length of stay (4 weeks)e

MD -0.01 (-0.56 to 0.54)

Mean stay ranged in control groups from 5 to 10 days

Mean stay in the intervention group was

0.01 shorter (0.56 shorter to 0.54 longer)

391 (4 RCTs)

⨁◯◯◯

VERY LOW j,l

Handgrip strength long term (up to 26 weeks) f

Not estimable

-

-

274 (2 RCTs)

⨁◯◯◯

VERY LOW j,k

Physical activity levels: light (before surgery)g

MD 2.59 (-9.7 to 14.8)

Mean levels ranged in control groups from 15 to 20

Mean levels in the intervention groups was 2.6 higher (10 lower to 15 higher)

150 (2 RCTs)

⨁◯◯◯

VERY LOW j,k

Physical activity levels: light (4 weeks)g

MD -1.08 (-7.23 to 5.07)

Mean levels ranged in control groups from 12 to 18

Mean levels in the intervention groups was 1 lower (7 lower to 5 higher)

131 (2 RCTs)

⨁◯◯◯

VERY LOW j,k

Physical activity levels: moderate (before surgery) g

MD 14.45 (12.8 to 16.1)

Mean levels ranged in control groups from 5 to 14

Mean levels in the intervention groups was 14 higher (13 higher to 16 higher)

150 (2 RCTs)

⨁◯◯◯

VERY LOW j,k

Physical activity levels: moderate (4 weeks) g

MD 0.15 (-3.03 to 3.33)

Mean levels ranged in control groups from 12 to 16

Mean levels in the intervention groups was 0.15 higher (3 lower to 3 higher)

131 (2 RCTs)

⨁◯◯◯

VERY LOW i,j

  1. aThe risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI Confidence interval, HRQoL Health-related quality of life, MD Mean Difference, RR Risk ratio
  2. bInternational Continence Society (ICS) ICS male questionnaire; Short Form Health Survey (SF-36 and -12); The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30): higher scores indicate better functioning (scaled from 0 to 100); The Functional Assessment of Cancer Therapy-Prostate (FACT-P): high scores indicate worse physical function
  3. cElbow flexion and extension strength: higher mobilized weight indicates higher levels of strength
  4. dThe Clavien-Dindo Classification; The Comprehensive Complication Index (ICC): high grades indicate worse outcome
  5. eAdministrative data: high number of days indicate worse response to intervention
  6. fHandgrip dynamometry: higher levels indicate better outcome
  7. gThe Community Healthy Activities Model Program for Seniors (CHAMPS): high scores indicate higher levels of physical activity (light, moderate, and vigorous)
  8. hDowngraded by two levels due to no blinding of personnel and outcome measurement (detection bias), and attrition bias
  9. iDowngraded by one level due to small sample size and wide confidence intervals (imprecision)
  10. jDowngraded by two levels due to no blinding of personnel (performance bias), and selective outcome reporting (reporting bias)
  11. kDowngraded by one level due to small sample size (imprecision)
  12. lDowngraded by one level due to wide confidence intervals (imprecision)
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Systematic Reviews

ISSN: 2046-4053