Exercise programme
Exercise was undertaken thrice weekly in small groups of 5–8 participants, supervised by accredited exercise physiologists in an exercise clinic. Each session was ~ 90 min and included resistance and aerobic exercises. Resistance training consists of exercises targeting major muscle groups, such as leg press, leg extension, leg curl, chest press, seated row, lat pulldown, triceps extension, biceps curl and calf raises (Singh et al. The aerobic-based component involved various modes of exercise such as treadmill walking/jogging and cycling or rowing on a stationary ergometer with intensity set at 60–80% of the individual participant’s estimated maximum heart rate (220—age in years) for 20–30 min. All sessions commenced with a warm-up comprising low-level aerobic exercise (~ 60% maximum heart rate) and stretching exercises for the major muscle groups and concluded with a cooldown of stretching exercises. Rehabilitation participants were instructed to maintain their customary physical activity and dietary patterns before surgery.