To the Editor:
We read with a great interest the article of Gillis et al.1 In this study, 77 patients undergoing colorectal resection for cancer were randomized to receive either prehabilitation or rehabilitation. Prehabilitation group was able to walk significantly further in 6 min, showing that a prehabilitation program could improve postoperative functional exercise capacity.
Rigorously, the authors scheduled in the study design to measure patients’ compliance to the postoperative rehabilitation program. This program was based on exercise, nutrition, and psychological interventions. It was reported in the study that the compliance to this trimodal rehabilitation program from surgery to 4-week period was significantly higher in the prehabilitation group than in the rehabilitation group (53 vs. 31%, respectively, P < 0.001). As a result, we could hypothesize that the enhance in exercise capacity observed in the prehabilitation group could be the result of a greater compliance to the postoperative program rather than the usefulness of a prehabilitation program.
We would like to know how the authors dealt with this problem.
The authors declare no competing interests.
(Accepted for publication February 21, 2015.)