# In-hospital moderate intensity interval training following surgical resection of foregut malignancy – a prospective single arm feasibility study

## TL;DR

This study shows that guided in-hospital exercise after foregut cancer surgery is safe, well-accepted, and does not harm patients' emotional well-being.

## Contribution

The first evaluation of in-hospital moderate intensity interval training as a post-surgical intervention for foregut malignancy patients.

## Key findings

- 90.5% of patients completed over 25% of exercise sessions, showing high participation.
- No training-related adverse events were recorded, confirming the safety of the intervention.
- Emotional quality of life was not negatively impacted by the exercise program.

## Abstract

Surgical resections of foregut malignancy are generally procedures with substantial morbidity and mortality. The use of exercise therapy has resulted in improvements in outcomes in many parts of the cancer treatment pathway and thus has become a standard addition to oncology and surgical oncology paradigms including during chemotherapy and as prehabilitation and rehabilitation for surgery. Guided in-hospital interval training as post-surgical therapy has not been evaluated as a treatment tool. If safe and acceptable to patients, this has the potential to improve surgical outcomes.

Twenty-one subjects were enrolled in a prospective single-arm trial of guided in-hospital, immediately postoperative moderate- (+) intensity interval training while recovering from a resection of foregut malignancy. A specific exercise program was designed for the postoperative setting and administered, aimed at achieving maximal intensity training during surgical recovery in the hospital environment. We hypothesized that this intervention would be safe, acceptable to patients, and would not negatively influence health-related quality of life. This was assessed by compliance with exercise sessions, the incidence of training-related complications, and the EORTC QLQ-30 and Hospital Anxiety and Depression scores.

Twenty-one patients were enrolled in this study (7 esophagectomies, 10 laparotomies, 4 laparoscopies). Participation in the program was high with 90.5% of subjects completing greater than 25% of all possible sessions and 71.4% of patients completing greater than 50% of possible sessions. There was no intervention-related adverse event. There was no reduction in emotional quality of life measures on discharge.

Administering a postoperative moderate- (+) intensity interval training program following recovery from major foregut surgery is acceptable to patients with high rates of participation. It is safe and does not result in a reduction in emotional health related quality of life.

The online version contains supplementary material available at 10.1007/s00520-026-10453-z.