Table 3

Donabedian conceptual framework of the included studies

Ref	Author	Aim/purpose	Structure	Process	Outcome
45	Jensen Laustsen et al	To evaluate the feasibility, the adherence and the efficacy of a short-term physical prehabilitation programme.	2-week preoperative exercise-based intervention were instructed by highly specialised physiotherapists dedicated to educate radical cystectomy patients.	It was recommended to repeat each exercise 10–15 times twice a day. Daily achievements were patient-reported in a personal dairy. Patients were contacted by ways of telephone call 1 week before surgery in order to answer questions regarding any concerns related to the programme or documentation of achievements.	A total of 66% adhered to the recommended progressive standardised exercise programme.
42	Porserud A, Sherif A and Tollbäck A	Test the feasibility and benefits of an exercise programme.	Exercise programme included group exercise training twice a week and daily walks.	The intervention group took part in a group exercise training programme. The training programme started within a week after the baseline assessment and its main aim was to increase physical function. Music was used as inspiration. The daily walks were reported by the patients in an exercise training diary.	A 12-week group exercise training programme was not feasible for most cystectomy patients.
39	Minnella at al.	To evaluate the feasibility of a preoperative multimodal intervention in radical cystectomy patients	Preoperative conditioning intervention included aerobic and resistance exercise, diet therapy, and relaxation techniques.	This study was conducted at an academic tertiary healthcare institution and enrolled adult patients scheduled for radical cystectomy.	Multimodal prehabilitation resulted in faster functional recovery after radical cystectomy.
37	Bente Thoft Jensen Jørgen Bjerggaard Jensen, Sussie laustsen, annemette	To test if a standardised preoperative and postoperative physical exercise programme can impact on HRQoL and inpatient satisfaction.	The intervention group received multimodal rehabilitation and an exercise- based intervention that involved both preoperative and postoperative exercises.	Patients were randomised to fast-track RC and intervention (n=50) or fast-track standard treatment (n=57). HRQoL and inpatient satisfaction was measured using valid questionnaires.	There was no difference in the global health score.
31	Banerjee S, Manley K, Shaw B, Lewis L, Cucato G, Mills R, Rochester M, Clark A and Saxton J M.	To test vigorous intensity aerobic interval exercise in BC patients prior to radical cystectomy.	Twice-weekly preoperative supervised vigorous intensity aerobic interval exercise in addition to standard treatment.	The exercise group was offered twice-weekly preoperative supervised vigorous intensity aerobic interval exercise in addition to standard treatment. The controls received standard treatment only. A repeat CPET was undertaken before surgery and postoperative recovery outcomes were recorded.	Improvements in peak values of oxygen pulse and power output were observed at the follow-up CPET in the exercise group versus controls.
34	Banerjee, S, Manley K, Thomas L, Shaw B, Saxton J, Mills R and Rochester M.	To evaluate if short preoperative course of supervised exercise sessions is tolerated and whether it can lead to an improvement in cardiopulmonary fitness.		Patients in the intervention arm were offered twice weekly supervised exercise sessions preoperatively for 4 weeks, while the control arm had standard care.	In the control group, VO₂ max was 22.8 (12.9–41.0) mL/kg/min, and the mean change was 0.48 mL/kg/min (−0.71 to 1.67) following the intervention. In the intervention arm initial average VO₂ max was 20.38 mL/kg/min, which increased to an average of 25.5 mL/kg/min.

CPET, cardiopulmonary exercise testing; HRQoL, health-related quality of life; VO₂, maximum rate of O₂ consumption.