Kinesiological insights into exercise prescription within oncological prehabilitation: current knowledge and future perspectives

Surgery is currently considered one of the cornerstones of cancer care, though postoperative complications remain high and drastically impact on length of hospital stay, mortality, psychophysical recovery, quality of life, and healthcare costs. Preoperative functional capacity has been widely recognized as a reliable predictor of postoperative recovery. In the last 20 years, consistent evidence has shown that multimodal prehabilitation programs integrating tailored physical exercise can effectively improve postoperative outcomes and counteract surgical complications by increasing preoperative physiological reserve and cardiopulmonary efficiency. Nevertheless, field specific research shows substantial heterogeneity and lack of standardization of exercise prescription thus struggling to provide cancer/surgery type-based customization. On this basis, the present perspective article aims to provide a critical analysis of the available literature about exercise prescription within cancer prehabilitation to shed light on the optimal testing and training methodologies and describe the current and future potentialities of kinesiology in this clinical context. Our literature overview highlighted that high-quality multicenter trials applying validated kinesiological parameters/tools are needed to develop effective tailored training interventions, foster accessibility, and evaluate potential long-term benefits of cancer prehabilitation. Furthermore, to address the current knowledge gap and facilitate large-scale implementation of prehabilitation, global public investments should recognize the crucial role of kinesiologists. Indeed, a stable integration of such professional figures into multidisciplinary prehabilitation teams could help meet the multidimensional complex needs of oncological patients and safely promote long-term health benefits.