Exercise snacking in surgical prehabilitation: leveraging the exerkine advantage to overcome adherence barriers in patients with cancer

Abstract

Prehabilitation aims to optimise physiological reserves before surgery; however, adherence to traditional exercise programmes remains limited, particularly among patients with cancer undergoing neoadjuvant therapy. Fatigue, time constraints, and competing responsibilities frequently preclude participation in long structured sessions. 'Exercise snacking', which involves brief, repeated bouts of vigorous activity performed throughout the day, offers a feasible alternative that could also provide superior physiological benefits through repeated pulses of bioactive molecules known as exerkines. These exerkines mediate anti-inflammatory, metabolic, neuroprotective, and immunomodulatory effects relevant to surgical recovery. We explore the biological rationale, translational potential, and equity advantages of exercise snacking in surgical prehabilitation.

Keywords: cancer surgery; exercise snacking; exerkines; high-intensity interval training; perioperative medicine; prehabilitation.