Purpose: Radiotherapy imposes a significant physiological and psychological burden on gynaecological cancer patients. Prehabilitation is being increasingly used to prepare individuals for cancer treatment and improve their well-being and resilience. Whilst prehabilitation has demonstrated benefit for individuals undergoing cancer surgery, the structure, role and implementation of prehabilitation prior to radiotherapy are poorly defined and relatively unexplored. This scoping review aims to provide a comprehensive overview of the current literature regarding prehabilitation interventions for individuals with gynaecological cancer undergoing radiotherapy. Methods: This review was conducted following the gold-standard Joanna Briggs Institute guidelines for scoping reviews. Literature searches were completed in October 2024 across: the Allied and Complementary Medicine Database; British Nursing Index; Cumulative Index to Nursing and Allied Health Literature; Cochrane library (Controlled trials and systematic reviews); Embase; Medical Literature Analysis and Retrieval System Online; and the Psychological Information Database. Grey literature searches were conducted via Google Scholar, Overton.io, and Trip Pro Medical Database. Results: Ninety records met the inclusion criteria, pertaining to 56 studies. Cervical cancer was the most represented gynaecological cancer type across studies. A small number of multimodal prehabilitation studies were identified (n = 4). Studies evaluating unimodal interventions were more common, with nutritional interventions (n = 24) being the most frequent, followed by psychological (n = 22) and physical exercise (n = 6) interventions. There was considerable variation across studies in respect to intervention initiation, duration, delivery and outcome measures. Conclusions: The physiological and psychological impacts of cancer diagnosis and treatment are closely entwined. Further development of multimodal prehabilitation to cohesively address these is an important area for future research. Studies evaluating exercise interventions are relatively unexplored in this patient population and the potential barriers to engagement must be considered. Future research should focus on complete and transparent reporting of interventions, with input from those with lived experience, and adopting a standardised set of outcome measures reported across all trials.

Carbohydrate supplementation optimises athletic performance, but the metabolic and performance impacts of commercial products/compositions are underexplored. We compared the efficacy of three commercial carbohydrate supplements: a glucose–fructose bar (GF‐Bar), a glucose–fructose hydrogel (GF‐Gel) and a maltodextrin‐based gel (MD‐Gel). Antegrade venous blood samples for glucose and insulin were measured alongside substrate utilisation in healthy Tier 2 athletes after ingesting 45 g of carbohydrates from the GF‐Bar, GF‐Gel and MD‐Gel during a modified 1‐h oral glucose tolerance test (OGTT). Additionally, the effect of supplementation on high‐intensity interval exercise was evaluated during repeated maximal sprint performance. During the OGTT, the GF‐Bar elicited greater total carbohydrate oxidation than MD‐Gel (24.6 ± 7.4 g vs. 17.8 ± 8.6 g, P = 0.038) but not GF‐Gel (20.1 ± 6.4 g, P > 0.05). Carbohydrate oxidation per minute varied over time ( P < 0.001) and between products ( P = 0.043), with GF‐Bar (0.27 ± 0.05 g min ⁻¹ ) showing higher oxidation than GF‐Gel (0.21 ± 0.05 g min ⁻¹ ) and MD‐Gel (0.19 ± 0.06 g min ⁻¹ ). No differences were observed in glucose peak, time to peak glucose or insulin concentration ( P > 0.05). Peak power ( P = 0.011), mean power ( P < 0.001) and total work varied across sprints ( P < 0.001) but not between products ( P > 0.05). Perceived exertion and gastrointestinal discomfort were similar between products ( P > 0.05). Despite differences in carbohydrate oxidation during the OGTT, the GF‐Bar, GF‐Gel and MD‐Gel displayed similar metabolic and sprint performance outcomes, suggesting that, within this study, carbohydrate formulation did not impact short‐duration maximal exercise.

During glucose uptake into muscle, GLUT‐4 can translocate with stimulus from insulin or muscle contraction via exercise, but some exercise‐intolerant populations are unable to benefit from improved glycaemic control. We investigated how passive movement training (PMT) and passive movement training with blood flow restriction (PMT+BFR) could be used as an alternative method. The effects on blood lactate and insulin were also investigated. Eleven healthy males (26.9 ± 8.3 years, 25.7 ± 2.1 kg/m ² ) undertook a crossover trial of three 150‐min treatments, control (CTRL), PMT and PMT+BFR, on three separate study visits, separated by ≥24 h. Each participant arrived fasted and consumed a standardised high‐carbohydrate meal (522 kcal, 112.5 g carbohydrate). The PMT protocol involved 30 min of intermittent bilateral knee extension/flexion (1 min:1 min work/rest) at an angular velocity of 180°/s through an 80° range of motion. PMT+BFR used a pressure calibrated at 80% arterial occlusion. Blood glucose and lactate were measured every 5 min, with insulin at 0, 30 and 60 min. Acute changes in muscle thickness were recorded using ultrasound pre‐ and post‐intervention. There were no significant differences between the treatment groups for mean glucose (CTRL: 4.59 ± 0.48, PMT: 4.88 ± 0.82, PMT+BFR: 4.51 ± 0.90 mmol/L; P = 0.498). A statistically significant acute difference of muscle thickness ( P = 0.00420) from pre‐ to post‐treatment was detected in PMT+BFR. While PMT did not improve postprandial glycaemia with or without BFR, the acute increase in muscle thickness after PMT+BFR suggests that it may be useful in other applications.

Carbohydrate supplementation plays a key role in optimising athletic performance. We compared the efficacy of three commercial carbohydrate supplements: a glucose-fructose bar (VOOM), a fructose-glucose hydrogel (MAU), and a maltodextrin-based gel (SIS). Antegrade venous blood samples for glucose and insulin were measured alongside substrate utilisation in healthy Tier 2 athletes after ingesting 45 g of carbohydrates from VOOM, MAU, and SIS during a modified 1-hour Oral Glucose Tolerance Test (OGTT). Additionally, the effect of supplementation on high-intensity interval exercise was evaluated during repeat maximal sprint performance. During the OGTT, VOOM elicited greater total carbohydrate oxidation than SIS (24.6 ± 7.4 g vs 17.8 ± 8.6 g, p = 0.03) but not MAU (20.1 ± 6.4 g, p > 0.05). Carbohydrate oxidation per minute varied over time (p < 0.0001) and between products (p = 0.04), with VOOM (0.27 ± 0.05 g·min⁻¹) showing higher oxidation than MAU (0.21 ± 0.05 g·min⁻¹) and SIS (0.19 ± 0.06 g·min⁻¹). No significant differences were observed in glucose peak, time to peak glucose, or total insulin concentration (p > 0.05). In the exercise trial, peak power (p < 0.01), mean power (p < 0.0001), and total work varied across subsequent sprints (p < 0.0001) but were not influenced by product (p > 0.05). Perceived exertion and gastrointestinal discomfort were similar between products (p > 0.05). Despite differences in carbohydrate oxidation during the OGTT, VOOM, MAU, and SIS displayed similar metabolic and sprint performance outcomes, suggesting that, within this study, carbohydrate formulation did not impact short-duration maximal exercise.