The Effectiveness of Exercise Rehabilitation or Prehabilitation in Cancer Survivors: A Protocol for Systematic Review and Meta-Analysis

Background In cancer, rehabilitation or prehabilitation interventions that improve cardiorespiratory fitness or exercise capacity are emerging as potentially effective for improving overall treatment outcomes. This systematic review protocol outlines a structure to evaluate best available trial evidence by assessing methodological quality and risk of bias of the evidence base, and conducting a meta-analysis using VO₂ max, the 6-Minute Walk Test and resource intensity of various clinical approaches. Objectives <ns3:list list-type="bullet"> <ns3:list-item> • Identify, synthesise and assess the best available evidence from randomised controlled trials on the effectiveness of exercise rehabilitation or prehabilitation in improving VO₂-Max and 6MWT distance among adults with cancer <ns3:list-item> • Examine how differences in intervention design (e.g. unimodal vs multimodal exercise interventions), underlying population characteristics and resource-use intensity influence observed outcomes, through a meta-analysis. <ns3:list-item> • Highlight the economic considerations that feed into program design and implementation for such interventions. Registration PROSPERO (CRD420261336025, 25 March 2026).