Physical exercise set as part of multimodal prehabilitation plan in patients with gynecological cancer undergoing abdominal cytoreductive surgery
Physical prehabilitation is a key element of multimodal preoperative care, but there is a lack of standardized, home-based exercise protocols, particularly in gynecological oncology. This gap, together with organizational barriers to supervised programs, may limit the feasibility and implementation of prehabilitation in many centers. The aim of this study was to present an original set of home-based physical exercises developed for patients with gynecological cancer undergoing cytoreductive surgery and to compare it with existing recommendations from the literature. A structured literature search was conducted in PubMed, Medline, EMBASE, and PsycINFO using predefined terms related to prehabilitation, cancer, and physical exercise. Eligible studies were reviewed by two independent investigators. Based on this review and clinical experience, we developed a set of aerobic and resistance exercises tailored to the needs of gynecological oncology patients, designed to be safe, feasible, and performed at home without specialized equipment. Eight studies describing prehabilitation exercise interventions were identified, of which only one addressed gynecological oncology specifically. Most existing programs relied on supervised or hybrid interventions and rarely provided detailed descriptions of exercises. In contrast, our proposed set includes structured aerobic activity and five resistance exercises focusing on abdominal, core, and paraspinal muscles, illustrated with infographics and supplemented with educational materials to ensure patient adherence at home. Evidence regarding home-based prehabilitation exercise programs in gynecological oncology remains scarce. Our proposed exercise set is, to our knowledge, the first detailed, practical, and reproducible home-based protocol for this patient population and may facilitate broader implementation of prehabilitation across oncological centers.