171646 20260527123126.0 doi 10.1371/journal.pone.0333649 sideral 149363 ART-2026-149363 eng Burgos-Bragado, José Manuel Asynchronous telerehabilitation in prehabilitation and postoperative recovery for colorectal cancer: A protocol for a randomized controlled trial 2026 Introduction Colorectal cancer (CRC) is a leading global malignancy, and surgery is frequently followed by complications, functional decline, and reduced quality of life. Multimodal prehabilitation and rehabilitation can improve physical recovery and psychosocial outcomes, but uptake is often limited by logistical and mobility barriers. Asynchronous telerehabilitation offers a flexible, patient-centered, and scalable approach; however, its effectiveness across the perioperative CRC pathway has not been rigorously evaluated. This trial will evaluate a multimodal asynchronous program delivered in prehabilitation and postoperative phases, against a booklet-based usual-care approach reflecting the pre-existing perioperative pathway in the study setting before trial initiation. Methods This single-blind, parallel-group randomized controlled trial will compare an asynchronous multimodal telerehabilitation program with a booklet-based usual-care program in adults scheduled for elective CRC resection. Fifty-six participants will be randomized 1:1 to the telerehabilitation group (HEFORA platform) or the usual-care control group. The intervention includes a 2-week prehabilitation phase and a 4-week postoperative rehabilitation phase. Assessments will be performed at five time points: baseline (pre-prehabilitation), post-prehabilitation (pre-surgery), post-surgery (pre-rehabilitation), post-rehabilitation, and 3-month Outcomes The primary outcome is functional capacity, measured by the Six-Minute Walk Test distance. Secondary outcomes include muscle strength, body composition, pulmonary function, physical activity, sleep quality, psychosocial variables, health-related quality of life, treatment expectancy, usability, satisfaction, and adherence. Analyses will follow the intention-to-treat principle using longitudinal models and sensitivity analyses for missing data and adherence. Conclusions: This study will provide evidence on the role of asynchronous telerehabilitation in perioperative colorectal cancer care. Positive results could inform clinical guidelines, promote wider adoption of digital rehabilitation strategies, and support a more accessible, patient-centered, and cost-effective approach to oncologic recovery. Access copy available to the general public Unrestricted info:eu-repo/grantAgreement/ES/DGA/B61-23D info:eu-repo/semantics/openAccess by https://creativecommons.org/licenses/by/4.0/deed.es info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Jiménez-Sánchez, Carolina Brandín de la Cruz, Natalia Carpallo-Porcar, Beatriz Roux-Ethève, Lilian Le Blas-Laina, Juan Luis (orcid)0000-0001-7004-4664 Alamillo-Salas, Jorge Gracia Gimeno, Paola Calvo, Sandra Universidad de Zaragoza (orcid)0000-0002-1674-7788 1006 413 Universidad de Zaragoza Dpto. Fisiatría y Enfermería Área Fisioterapia 21, 4 (2026), e0333649 [23 pp.] PLoS One PLoS ONE 1932-6203 1149037 http://zaguan.unizar.es/record/171646/files/texto_completo.pdf Versión publicada 2118776 http://zaguan.unizar.es/record/171646/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:171646 articulos driver 2026-05-27-11:25:42 ARTICLE