Maarten van Egmond

16 Chapter 1 and to develop a tailored pre- and/ or postoperative physiotherapeutic intervention. This intervention could then be offered in the patient’s own environment with telerehabilitation under supervision of an experienced physiotherapist. Chapter 2 describes the association of preoperative physical functioning and postoperative complications in patients with esophageal cancer undergoing elective surgery. Preoperative functional status is a risk factor for developing postoperative complications in major abdominal and thoracic surgery, but this has hardly been evaluated in patients with esophageal cancer undergoing esophagectomy. Chapter 3 outlines the pre-and postoperative course of physical functioning in patients with esophageal cancer who underwent surgery and describes the course of functional status in patients with and without postoperative complications. Chapter 4 describes the relation between preoperative muscle mass and handgrip strength, respiratory muscle strength and functional lower extremity strength in patients with esophageal cancer awaiting surgery, prior to neoadjuvant chemoradiation. If an association between muscle mass and muscle strength is found, physiotherapists might be able to measure functional muscle strength as an early predictor for the consequences for functional performance due to decreased muscle mass and eventually sarcopenia. Chapter 5 contains a systematic review and meta-analysis of randomized controlled trials, controlled clinical trials, quasi-randomized and quasi-experimental designs with comparative controls evaluating the effects of telerehabilitation on postoperative outcomes and quality of life in surgical patients. We also determined if telerehabilitation increased patient satisfaction. Chapter 6 describes the feasibility and preliminary effectiveness of a 12-week postoperative physiotherapy intervention with telerehabilitation for patients with esophageal cancer treated with esophagectomy and suffering from postoperative complications. Chapter 7 describes the main findings, strengths and limitations, clinical relevance and recommendations for future research. A summary in English and Dutch will finally conclude the thesis.