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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program

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Immune Modulation by Personalized vs. Standard Prehabilitation Before Major Surgery: A Randomized Controlled Trial.

Amélie Cambriel, Amy Tsai, Benjamin Choisy

Medrxiv : the Preprint Server for Health Sciences

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Summary

This summary is machine-generated.

Personalized prehabilitation significantly improved physical and cognitive function and reduced surgical complications by modulating the immune system. Standard prehab showed minimal benefits, highlighting the importance of tailored interventions for optimizing surgical readiness and recovery.

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Area of Science:

Immunology
Surgery
Personalized Medicine

Background:

Prehabilitation (prehab) programs aim to improve surgical outcomes but lack personalized, pathophysiologically-driven implementation.
The efficacy of standard prehab is debated due to limited individual tailoring.

Purpose of the Study:

To assess the impact of personalized versus standard prehabilitation on preoperative physical, cognitive, and immune function.
To evaluate the effect of prehab on postoperative outcomes in patients undergoing major elective surgery.

Main Methods:

A prospective, single-blinded, randomized trial involving 58 patients undergoing major elective surgery.
Patients were randomized to either standard (paper-based) or personalized (remote coaching) prehab programs.
Immune function was assessed using mass cytometry, alongside physical and cognitive performance measures.

Main Results:

The personalized prehab group showed significant improvements in physical function (6MWT; p=0.03) and fewer severe postoperative complications (4 vs. 11; p=0.04).
Personalized prehab induced profound, cell-type specific immune alterations, dampening pro-inflammatory signaling (AUROC=0.88).
The standard prehab group had moderate clinical improvements but no significant immune changes (AUROC=0.63).

Conclusions:

Personalized prehabilitation effectively modulates the immune system, dampening inflammatory responses linked to surgical complications.
These immune changes correlate with improved physical and cognitive function and reduced postoperative complications.
Findings support personalized prehab for optimizing surgical readiness and suggest a pathway for biologically-driven patient stratification.