Prehab topics
Find out more about the eight key risk factors by visiting our Prehab topics pages.
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Physical activity and exercise
Enjoy the knowledge check, watch our video and download top tips for your patients. Keep scrolling to see the research and signposts…
“If exercise could be packed into a pill, it would be the single most widely prescribed and beneficial medicine in the nation.”
Dr Robert Butler
Former Director at National Institute on Aging
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Watch our video
Physical activity can have a significant impact on outcomes and quality of life, helping patients to prepare their bodies for the stresses of treatment.
The difference between physical activity and exercise...
Physical activity is any bodily movement, such as walking up the stairs, doing your shopping or taking the dog for a walk. A subset of physical activity is exercise.
Exercise is a more planned and structured session, where there is a goal in mind, such as improving strength. Examples include running, a gym class, yoga or cycling.
Being active
Getting your patients moving...
It is important for your patients to be active. Encourage them to be physically active every day, with regular exercise throughout the week. Some movement is better than none, but more is even better.
A good goal for patients is to aim to meet the Chief Medical Officers’ (CMO) recommended weekly physical activity levels before treatment.
The CMO guidelines recommend at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity.
The guidelines recommend muscle-strengthening sessions involving all major muscle groups twice a week, using body weight, resistance bands or weights.
There are additional recommendations for older adults, who will also benefit from including balance exercises twice a week as this will help reduce the risk of falls.
We should all aim to be physically active every day and break up long periods of sitting with activity, such as a march on the spot, a few squats or wall press ups.
Moderate = breathing increases, heart beats faster, but you can still talk. Vigorous = heart/breathing is faster, sweating and can’t hold a conversation.
Rate of Perceived Exertion (RPE)
RPE Scale
Improving fitness before treatment can have a positive impact. A structured exercise programme is the best way to do this in a short time frame. This will look different for everyone, depending on current fitness levels.
If a patient’s fitness is low, even a small amount of extra activity can have a huge impact. Patients who are already active can add more structure with an exercise programme.
To gain the most benefits, patients should work at a moderate intensity, roughly a 6-7/10 on the Rate of Perceived Exertion scale. This means they can feel an increase in heart rate, and might be getting warmer and sweating.
View our physical
activity top tips for
your patients here...
FAQS
The importance of movement and the consequences of inactivity.
What are the benefits of physical activity?
Evidence shows that being physically active can help people of all ages lead healthier and happier lives. Exercise can reduce the risk of major illnesses and lower the risk of early death by up to 30%. Research also shows that physical activity can boost self-esteem, mood, sleep quality and energy, as well as reducing stress.
How many people meet the guidelines?
Physical activity levels are slowly improving over time. In 2023, around 60% of people in the North East were hitting recommended levels. This was below the national level of just over 63%. While 60.5% of people were meeting the 150 minutes of activity per week, only 44% met the guidelines for strength training. This declines with age, with only 30% of over 75s meeting recommendations.
Why is physical activity a key part of prehab?
We know that improvements in fitness before treatment can reduce the chance of complications and lead to a smoother recovery. If patients are having neoadjuvant treatment (chemo or radiotherapy before surgery), this can lead to a significant reduction in aerobic fitness. By continuing physical activity and exercise through treatment, the impact of this can be reduced.
Why exercise all the way through life?
By continuing to exercise through life, you can reduce the risk of some cancers, cancer reoccurrence, cardiovascular disease, stroke, diabetes, depression and low mood.
Why is it important to promote exercise?
Exercise as part of prehabilitation prepares patients for a drop in physical fitness, which ultimately helps them recover quicker. The type of exercise will vary from patient to patient. For most, exercise is safe. However, there will be some who have additional risk factors, such as bone metastasis, recent cardiac event or uncontrolled diabetes, who will need a further conversation with their GP, physiotherapist or exercise specialist before starting a new exercise programme.
How can you help your patients?
There are number of options available, including…
- Self-directed exercise +/- supporting resources as available (paper/digital).
- GP referral/exercise referral programmes, if available.
- Prehabilitation programmes, if available.
Encouraging them to do some activity even if it’s a short walk and a few squats to stands.
Links
Signposting
Your patients may be entitled to a GP referral for exercise schemes at local gyms. There may also be local services such as a prehabilitation service, waiting well or exercise on referral.
Click the tabs below
Various websites have been developed to help people safely increase their physical activity.
Click the links on the right to see the resources.
There are also apps available to support your patients.
Click the links on the right to see the resources.
