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Better in - Better out

Overall aim

To identify older people at risk for complications after major abdominal oncological surgery and to evaluate the effects of a preoperative training program for older persons at risk.

Project description

The study consists of an observational study and a randomized controlled trial (RCT). It is part of a larger international co-operation. It is a joint study between the Academic primary healthcare center, Karolinska University Hospital, The South General Hospital, Ersta Hospital and Karolinska Institutet.

The observational study has been completed and analyses are ongoing. A feasibility study of the RCT has also been completed and analyses are ongoing. A qualitative study with the aim to describe perceptions and views on preoperative physical activity and exercise in older people waiting for colorectal cancer surgery is ongoing. Patients remitted for major abdominal oncological surgery at the hospitals have been recruited and included after informed consent. In the observational study, physical activity level and physical function were assessed before the operation. Up to three months after surgery, post-operative complications, length of stay and mortality have been recorded. The RCT will be based on the results of the observational study regarding inclusion criteria and power calculation. In the feasibility study, physical function and respiratory function were assessed at the hospital before the intervention, the day before surgery and the day before discharge. At baseline and six months after surgery, the participants received three questionnaires about the level of independence in daily living, level of physical activity and health related quality of life. The intervention in the RCT were performed in the older person’s home, led by physiotherapists working in primary care. The intervention consisted of a combination of respiratory training and individually adjusted functional exercise, which has not been evaluated previously.

If the study shows positive effects, it can be of great importance for older persons’ independence and quality of life as well as from a socioeconomic perspective.

Primary investigator


Elisabeth Rydwik

Telefon: 08-524 888 18
Enhet: Sektionen för fysioterapi

Project members

Erika Franzén

Malin Nygren-Bonnier

Mia Bergenmar, University nurse, Center for Digestive Diseases, Karolinska University Hospital

Emelie Karlsson, PhD-student

Monika Egenvall, Surgeon, PhD, Center for Digestive Diseases, Karolinska University Hospital

Bengt Isaksson, Surgeon, PhD, Center for Digestive Diseases, Karolinska University Hospital

Parastou Farahnak, Surgeon, PhD, Surgical departement at Stockholm South General Hospital

Financial support

Stockholm County Council research funds