Prehabilitation Program for Abdominal Plastic Surgery

Recruiting at 1 trial location

Overseen By Cara Black, PGY-2

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Stanford University

Disqualifiers: Non-English speakers, No smartphone, Other intervention, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 13

520 Participants Needed

Trial Summary

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Prehabilitation Program for Abdominal Plastic Surgery?

Research shows that prehabilitation programs, which include exercise, nutrition, and mental preparation, can improve recovery after major abdominal surgeries by enhancing patients' physical and mental readiness before surgery. ^{1 2 3 4 5}

Is the Prehabilitation Program for Abdominal Plastic Surgery safe for humans?

Prehabilitation programs, which include exercise, nutrition, and psychological support before surgery, have been shown to reduce complications and improve recovery in various surgeries, suggesting they are generally safe for humans. ^{2 6 7 8 9}

How does the prehabilitation program differ from other treatments for abdominal plastic surgery?

The prehabilitation program is unique because it focuses on preparing patients for surgery by improving their physical condition, nutrition, and mental well-being before the procedure. This approach aims to enhance recovery and reduce complications, unlike traditional treatments that primarily focus on post-surgery care. ^{1 2 8 10 11}

What is the purpose of this trial?

The purpose of this study is to determine whether a program to optimize patient physical fitness and nutrition ("prehabilitation") prior to and after plastic surgery involving the abdomen improves surgical outcomes. The investigators hope to determine how a multimodal peri-operative prehabilitation program can be most effective in engaging and motivating patients to physically and mentally get ready for an abdominally-based plastic surgery operation. The overall goal is to determine if this program will improve post-operative recovery after abdominally-based plastic surgery. The importance of this new knowledge is better understanding of ways that plastic surgeons can improve outcomes, engagement, and experience of patients undergoing abdominally-based plastic surgery operations. This would translate to increased healthcare value and better long-term outcomes.

Research Team

Cara Black, MD

Principal Investigator

Resident

Cindy Kin, MD

Principal Investigator

Asst Prof-Med Ctr Line

Eligibility Criteria

This trial is for adults over 18 planning to have elective abdominally-based plastic surgery in at least 3 weeks by specific surgeons. Participants must speak English and have access to a smartphone or internet. Those involved in other nutrition/exercise studies can't join.

Inclusion Criteria

I am over 18 and scheduled for elective abdominal surgery with a specified surgeon in 3+ weeks.

Exclusion Criteria

Patients who do not have access to a smartphone or internet/cell service

Patients who are undergoing another intervention study that consists of a nutrition and/or exercise behavior change.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Prehabilitation

Participants engage in a prehabilitation program to optimize physical fitness and nutrition before surgery

2 weeks

1 visit (virtual)

Surgery

Participants undergo abdominally-based plastic surgery

1 day

Post-operative Recovery

Participants are monitored for recovery and surgical outcomes

12 months

Multiple visits (in-person and virtual) over 12 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

12 months

Treatment Details

Interventions

• Prehabilitation Program

Trial Overview The study tests if a 'prehabilitation' program, focusing on improving physical fitness and nutrition before and after surgery, leads to better recovery outcomes from abdominally-based plastic surgeries.

Participant Groups

Group I: Prehab Intervention Arm Experimental Treatment 1 Intervention

The intervention arm will receive access to the prehab program (abdominal workout videos) and surveys via RedCAP.The program will start no less than 14 days before the date of surgery.

Group II: Control Active Control 1 Intervention

The control arm will receive no additional prehabilitation material prior to material. Rather, they will receive standard preoperative care in which they will be given standard advice on nutrition and fitness. REDcap surveys will be administered.

Who Is Running the Clinical Trial?

Stanford University

Lead Sponsor

Trials

2,527

Recruited

17,430,000+

Findings from Research

Prehabilitation programs for patients undergoing major abdominal cancer surgery include a mix of exercise, nutritional, and psychological interventions, but their composition and delivery methods vary widely across studies, indicating a need for standardization.

In a review of 9 studies involving 549 patients, no significant differences in post-operative complications were found between prehabilitation and standard care, suggesting that while prehabilitation may optimize recovery, its impact on reducing complications needs further investigation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A systematic review of prehabilitation programs in abdominal cancer surgery. Hijazi, Y., Gondal, U., Aziz, O.[2022]

Prehabilitation is a promising approach that prepares patients for major abdominal surgeries by improving their overall health and functional capacity, potentially leading to better postoperative outcomes.

The study reviews various methods for selecting patients for prehabilitation programs and suggests implementation strategies, highlighting its importance in reducing stress and adverse effects associated with surgical procedures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prehabilitation: how to prepare our patients for elective major abdominal surgeries? Gonçalves, CG., Groth, AK.[2020]

A systematic review of eight randomized controlled trials involving 442 patients found that preoperative exercise training significantly reduced postoperative pulmonary complications and overall morbidity compared to standard care.

Despite the benefits in reducing complications, prehabilitation did not significantly shorten the length of hospital stay, indicating that while it improves recovery, it may not affect hospitalization duration.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Systematic Review and Meta-analysis of Physical Exercise Prehabilitation in Major Abdominal Surgery (PROSPERO 2017 CRD42017080366). Heger, P., Probst, P., Wiskemann, J., et al.[2021]

Prehabilitation, which involves preoperative interventions targeting physical, nutritional, and mental health, can significantly enhance postoperative outcomes by optimizing patients' conditions before surgery.

A multidisciplinary approach to prehabilitation creates a synergistic effect, leading to improved recovery, and although more high-quality evidence is needed, prehabilitation programs are being implemented globally, transforming perioperative care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prehabilitation, making patients fit for surgery - a new frontier in perioperative care. Molenaar, CJL., Papen-Botterhuis, NE., Herrle, F., et al.[2021]

A systematic review of 16 studies involving 2591 patients found that total body prehabilitation, which includes exercise, nutrition, and psychological support, can reduce post-operative complications in major abdominal surgery, particularly in malnourished patients.

A multimodal prehabilitation approach appears to improve functional outcomes more effectively than single-modality programs, but the variability in study designs means there is not enough data to recommend a specific prehabilitation protocol for routine clinical use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of Total Body Prehabilitation on Post-Operative Outcomes After Major Abdominal Surgery: A Systematic Review. Luther, A., Gabriel, J., Watson, RP., et al.[2022]

A 4-week prehabilitation program involving physical therapy, nutritional support, and psychological preparation was safely implemented in 60 out of 106 patients scheduled for major abdominal surgery, with no cardiovascular events reported during the program.

Patients showed significant improvements in physical function (6-minute walking distance increased by 9.3%) and psychological well-being, suggesting that prehabilitation can enhance recovery and quality of life before surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prehabilitation before major abdominal surgery: Evaluation of the impact of a perioperative clinical pathway, a pilot study. Boukili, IE., Flaris, AN., Mercier, F., et al.[2022]

Prehabilitation, which focuses on improving patients' functional capacity and managing risks before surgery, has been shown to reduce post-operative complications and improve overall outcomes in various surgical procedures, including lung cancer resection and coronary artery bypass grafting.

Incorporating prehabilitation alongside traditional rehabilitation not only enhances physical function but also lowers the risk of adverse events, helping patients return to normal activities more effectively after surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prehabilitation Coming of Age: IMPLICATIONS FOR CARDIAC AND PULMONARY REHABILITATION. Myers, J., Niebauer, J., Humphrey, R.[2023]

Prehabilitation programs, which focus on improving physical condition, nutrition, and cognitive health, aim to reduce postoperative complications by optimizing patients from diagnosis to surgery.

These programs have synergistic effects, where small individual improvements combine to significantly enhance postoperative recovery, highlighting the need for their integration into routine clinical practice despite the need for more research on their impact across various patient groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Narrative Review About Prehabilitation in Surgery: Current Situation and Future Perspectives. López Rodríguez-Arias, F., Sánchez-Guillén, L., Armañanzas Ruiz, LI., et al.[2021]

Prehabilitation, which includes physical exercise, nutritional, and psychological support before surgery, has been shown to improve cardiopulmonary fitness and reduce postoperative complications, leading to better recovery outcomes.

Current evidence suggests that individualized prehabilitation programs, which can be home-based or supervised in hospitals, are essential for maximizing effectiveness, although more research is needed to determine the optimal structure of these programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prehabilitation, improving postoperative outcomes. Chmelo, J., Chmelová, I., Phillips, AW.[2021]

A multimodal prehabilitation program combining exercise, nutritional support, and mindfulness training was successfully implemented in patients preparing for elective cardiac surgery, with 45 days of participation and no reported complications.

The program significantly improved patients' functional capacity, as shown by increased performance in the six-minute walking test and chair test, suggesting potential benefits for recovery after surgery, although further research is needed to confirm its impact on postoperative outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and effects of prehabilitation in cardiac surgery. Preliminary study. López-Hernández, A., Arguis, MJ., Gimeno-Santos, E., et al.[2023]

A systematic review of 33 studies involving 3167 citations found that prehabilitation did not significantly improve postoperative function, quality of life, or pain in patients undergoing knee or hip arthroplasty for osteoarthritis.

However, prehabilitation programs lasting over 500 minutes may reduce the need for postoperative rehabilitation, indicating a potential benefit in healthcare utilization, even though no significant reductions in readmissions or nursing home placements were observed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of prehabilitation or preoperative exercise for surgical patients: a systematic review. Cabilan, CJ., Hines, S., Munday, J.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

A systematic review of prehabilitation programs in abdominal cancer surgery. [2022]

2. Brazil pubmed.ncbi.nlm.nih.gov

Prehabilitation: how to prepare our patients for elective major abdominal surgeries? [2020]

3. United States pubmed.ncbi.nlm.nih.gov

A Systematic Review and Meta-analysis of Physical Exercise Prehabilitation in Major Abdominal Surgery (PROSPERO 2017 CRD42017080366). [2021]

4. Germany pubmed.ncbi.nlm.nih.gov

Prehabilitation, making patients fit for surgery - a new frontier in perioperative care. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

The Impact of Total Body Prehabilitation on Post-Operative Outcomes After Major Abdominal Surgery: A Systematic Review. [2022]

6. England pubmed.ncbi.nlm.nih.gov

Prehabilitation before major abdominal surgery: Evaluation of the impact of a perioperative clinical pathway, a pilot study. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Prehabilitation Coming of Age: IMPLICATIONS FOR CARDIAC AND PULMONARY REHABILITATION. [2023]

8. Spain pubmed.ncbi.nlm.nih.gov

A Narrative Review About Prehabilitation in Surgery: Current Situation and Future Perspectives. [2021]

9. Czech Republic pubmed.ncbi.nlm.nih.gov

Prehabilitation, improving postoperative outcomes. [2021]

10. Spain pubmed.ncbi.nlm.nih.gov

Feasibility and effects of prehabilitation in cardiac surgery. Preliminary study. [2023]

11. Australia pubmed.ncbi.nlm.nih.gov

The effectiveness of prehabilitation or preoperative exercise for surgical patients: a systematic review. [2022]