Nutrition (NUT) Participants will receive standard clinical care combined with nutrition education and protein-enriched soy milk supplementation for approximately 2 weeks before surgery and about 3 weeks after hospital discharge.

Exercise and Nutrition Group (EN)

Participants will receive peri-habilitation exercise training in combination with nutritional intervention, including carbohydrate plus protein-enriched soy milk supplementation twice daily (before and after exercise), for approximately 2 weeks before surgery and about 3 weeks after hospital discharge.

Nutrition Group (NUT) Participants will receive standard clinical care combined with nutrition education and protein-enriched soy milk supplementation for approximately 2 weeks before surgery and about 3 weeks after hospital discharge.

• Time to walk 4 meters (or 3 meters) at a normal, comfortable pace.
• Seconds(sec)
• Lower values(seconds) indicate better performance (faster walking speed)

• Time to stand up and sit down 5 times from a chair without using the arms.
• Seconds(sec)
• Lower values(seconds) indicate better performance.

• Time maintaining balance in three positions (feet together, semi-tandem, and tandem stance). The maximum time allowed for each position is 10 seconds.
• Seconds(sec)
• Higher values(seconds) indicate better performance.

• Time to stand up from a chair, walk 3 meters, turn around, walk back, and sit down.
• Seconds(sec)
• Lower values(seconds) indicate better performance.

• Cardiovascular status assessed using electrocardiogram (ECG)
• N/A (qualitative/clinical assessment)
• Abnormal ECG findings indicate impaired cardiovascular function.