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Multi-Component Prehabilitation Program for Older Adults Undergoing Major Elective Surgery: A Pilot and Feasibility

Kuan-Yuan Wang1,2,3, Kailin Xu1, Yuchen Liu4

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Summary

This study shows that a multi-component prehabilitation program is feasible for older adults undergoing major surgery. The program improved physical function and showed high adherence rates, suggesting potential benefits for surgical recovery.

Keywords:
clinical trialfeasibilityprehabilitationsurgery

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Area of Science:

  • Geriatric Medicine
  • Surgical Oncology
  • Rehabilitation Medicine

Background:

  • Prehabilitation programs aim to improve surgical outcomes in older adults.
  • Adherence to prehabilitation programs can be variable.
  • Assessing the feasibility of a multi-component prehabilitation program is crucial.

Purpose of the Study:

  • To assess the feasibility of an individualized, multi-component prehabilitation program for older adults undergoing major elective surgery.
  • To evaluate adherence rates to different components of the prehabilitation program.
  • To examine the impact of prehabilitation on physical function and patient-reported outcomes post-surgery.

Main Methods:

  • A single-arm trial was conducted at an academic medical center.
  • The program included physical therapy, dietician consultations with protein supplementation, and group meditation for 3-4 weeks.
  • Feasibility was measured by adherence rates; secondary outcomes included changes in gait speed, chair stands, grip strength, and PROMIS-Physical Function scores.

Main Results:

  • 30 older adults (mean age 75.3 years) were enrolled, with 28 starting the intervention.
  • High adherence rates were observed: 91.3% for physical therapy, 76.9% for dietician consultations, and 68.3% for meditation.
  • Significant improvements were noted in walking speed and chair stand times, and PROMIS-Physical Function scores improved by 4.4 points at 90 days post-surgery.

Conclusions:

  • Multicomponent prehabilitation is feasible in older patients scheduled for major elective surgery.
  • The program demonstrated good adherence and positive effects on physical function.
  • Further research is warranted to confirm these findings in larger, randomized controlled trials.