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Prehabilitation is a concept that challenges the traditional models of recovery by initiating the recovery process preoperatively. Improvement of physical capacity by means of prehabilitation may facilitate better recovery after surgery.
The aim of the present study is to evaluate the impact of preoperative physical exercise training (prehabilitation) on postoperative recovery and clinical outcomes after major abdominal surgery.
Major abdominal surgery is a great stressor to patients and causes large physiological changes, leads to tissue trauma, immobility, psychological distress and reduced quality of life. Physical capacity appears to be an important predictor for postoperative recovery after major abdominal surgery. Prehabilitation is a concept that challenges the traditional models of recovery by initiating the recovery process preoperatively. Improvement of physical capacity by means of prehabilitation may facilitate better recovery after surgery. More specifically prior to major abdominal surgery, preoperative exercise therapy is associated with improved physical fitness of patients, but whether or not this results in fewer complications or faster convalescence remains unclear.
The aim of the present study is to evaluate the impact of preoperative physical exercise training (prehabilitation) on postoperative recovery and clinical outcomes after major abdominal surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Prehabilitation | Experimental | The patients will undergo an exercise test on a cycle ergometer (VO2 max), a grip strength test (Jamar dynamometer), a Time Up and Go (TUG) test and a 6 Minutes Walking Test (6-MWT), before and after prehabilitation. Intervention involves 3 training sessions per week during 3 weeks preoperatively, according to the high intensity interval training model, wich consists of:
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| Controls | No Intervention | The patients will also undergo an exercise test on a cycle ergometer, a grip strength test (Jamar dynamometer), a TUG-test and a 6-MWT, but only once preoperatively, and between 4 and 6 weeks and 8 and 10 week postoperatively. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Prehabilitation | Other |
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| Measure | Description | Time Frame |
|---|---|---|
| Postoperative morbidity | Comprehensive Complication Index (CCI) | Up to 30 postoperative days |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative most severe complication | Clavien classification | Up to 30 postoperative days |
| Length of stay | From the day of hospitalization to the exit |
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Inclusion Criteria:
Elective major abdominal surgery:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Martin Hübner | University Hospital CHUV | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Visceral Surgery, University Hospital Center | Lausanne | 1011 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35392968 | Derived | Michel A, Gremeaux V, Muff G, Pache B, Geinoz S, Larcinese A, Benaim C, Kayser B, Demartines N, Hubner M, Martin D, Besson C. Short term high-intensity interval training in patients scheduled for major abdominal surgery increases aerobic fitness. BMC Sports Sci Med Rehabil. 2022 Apr 7;14(1):61. doi: 10.1186/s13102-022-00454-w. |
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| ID | Term |
|---|---|
| D000082622 | Preoperative Exercise |
| ID | Term |
|---|---|
| D019990 | Perioperative Care |
| D005791 | Patient Care |
| D013812 | Therapeutics |
| D013514 | Surgical Procedures, Operative |
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| Up to 30 postoperative days |
| Readmission rates | Any readmission to the hospital | Up to 30 postoperative days |
| Exercise capacity | Exercise testing on a cycloergometer(VO2 max) | At 3 and 1 week preoperatively |
| Life satisfaction | Specific questionnaire (EORTC:European Organisation for Research and Treatment of Cancer) | At 3 and 1 week preoperatively, then at 4 and 8 weeks postoperatively |
| Biological inflammatory response | C-reactiv protein (CRP) measure | Up to 3 postoperative days |
| Exercise capacity | Time up and go test | At 3 and 1 week preoperatively, then at 4 and 8 weeks postoperatively |
| Walking capacity | 6 minutes Walking Test | At 3 and 1 week preoperatively, then at 4 and 8 weeks postoperatively |
| Happiness | Specific questionnaire (EMMBEP questionnaire) | At 3 and 1 week preoperatively, then at 4 and 8 weeks postoperatively |
| Nutritional response | Albumin measure | Up to 3 postoperative days |
| D015444 |
| Exercise |
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |