Purpose: To identify subgroups of patients with oesophageal cancer based on exercise intensity
during prehabilitation, and to investigate whether training outcomes varied between subgroups.
Materials and methods: Data from a multicentre cohort study were used, involving participants
following prehabilitation before oesophagectomy. Hierarchical cluster analysis was performed using
four cluster variables (intensity of aerobic exercise, the Borg score during resistance exercise, intensity
of physical activity, and degree of fatigue). Aerobic capacity and muscle strength were estimated
before and after prehabilitation.

Results: In 64 participants, three clusters were identified based on exercise intensity. Cluster 1 (n = 23)
was characterised by fatigue and physical inactivity, cluster 2 (n = 9) by a low training capacity, despite
high physical activity levels, and cluster 3 (n = 32) by a high training capacity. Cluster 1 showed the
greatest improvement in aerobic capacity (p = 0.37) and hand grip strength (p = 0.03) during
prehabilitation compared with other clusters.

Conclusions: This cluster analysis identified three subgroups with distinct patterns in exercise intensity
during prehabilitation. Participants who were physically fit were able to train at high intensity. Fatigued
participants trained at lower intensity but showed the greatest improvement. A small group of
participants, despite being physically active, had a low training capacity and could be considered frail.