Effects of Aerobic Exercise on Skeletal Muscle Remodeling in Colorectal Cancer (RESTORE)

Inclusion Criteria: Age ≥18 years Histologically confirmed stage I, II, or III colon or rectal cancer Completed surgical resection with curative intent Completed other cancer-directed treatments Engage in <150 minutes per week of moderate- to vigorous-intensity structured endurance exercise No planned major surgery during the study period Readiness to exercise, as determined by a modified version of the Physical Activity Readiness Questionnaire Ability to provide written informed consent Provide written approval by a qualified healthcare professional Willing to be randomized Exclusion Criteria: Evidence of metastatic or recurrent colorectal cancer Concurrently actively treated other (non-colorectal) cancer Scheduled to receive other postoperative cancer-directed treatment(s) Currently pregnant, breastfeeding, or planning to become pregnant within the next 24 weeks Currently participating in another study with competing outcomes Contraindications to magnetic resonance imaging Any dietary condition or restriction that would limit tolerance of a mixed meal challenge Any other cardiovascular, pulmonary, orthopedic, neurologic, psychiatric, or other condition that, in the investigator's opinion, would preclude participation or successful compliance with the protocol Any other situation that, in the opinion of the investigator, would negatively impact subject safety or successful compliance with the protocol