Trimodal Prehabilitation in Patients Undergoing Elective Surgery

Study Overview
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Brief Summary
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Patients scheduled for elective surgery will undergo 4 week course of trimodal prehabilitation

Detailed Description
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Patients with high surgical risk will participate in 4 week prehabilitation that will consist of 4 stationary sessions - one per week - comprised of: physiotherapy session, psychological session and nutritional advice. During first session each patient will receive an activity monitor and dedicated mobile app that will record his daily performance.

Official Title
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The Influence of Prehabilitation on the Surgical Patients Condition

Conditions
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Cardiac Complication, Perioperative Complication

Intervention / Treatment
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* Other: 4 week trimodal prehabilitation course


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age > 70 and/or American Society of American Society of Anesthesiologists Physical Status Classification System (ASA) 3-4 Unfit patients Exclusion Criteria: physical condition that makes the patient is not able to perform rehabilitation exercises cardiac and respiratory instability or high risk of its occurrence inability to use electronic devices used in the study

Ages Eligible for Study
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Minimum Age: 19 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Trimodal prehabilitation<br>Patients qualified for elective surgery that meet criteria for prehabilitation | Other: 4 week trimodal prehabilitation course<br>* trimodal prehabilitation in mixed: stationary and at-home structure<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 6 minute walk test | change in aerobic capacity | baseline and pre surgery | 
| Yale Physical Activity Survey (YPAS) | change in physical activity | baseline and pre surgery | 
| self-perceived health status scale (36-Item Short Form Survey - SF36) | change in self-perceived health status (0 - min, 100 - max self perceived health score) | baseline and pre surgery | 
| Global Leadership Initiative on Malnutrition (GLIM) scale | change in nutritional status - malnutrition diagnosed if one phenotypical and one etiological criteria are fulfilled Severity based on phenotypic criteria: minimal value (moderate malnutrition) max value (severe malnutrition) | baseline and pre surgery | 
| Hospital Anxiety and Depression (HAD) scale | change in psychological status: depression and anxiety criteria 0 points min score - low level od depression and anxiety 21 max score | baseline and pre surgery | 
| motivation questionaire (MQ) | change in patient's motivation 0-10 0 - low motiwation 10 max motivation | baseline and pre surgery | 
| Perceives stress - Perceived Stress Questionaire (PSS) | stress level - 0 - min value - no perceived stress 20 - maximal preceived stress | baseline and pre surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants requiring reintervention during initial hospitalization |  | 3 months after surgery | 
| ICU length of stay |  | 3 months after surgery | 
| Total hospital length of stay |  | 3 months after surgery | 
| Number of Patients requiring Emergency room visits and hospital readmissions |  | at 30 days | 
| Number of Patients with postoperative complications | number and severity | 3 month after surgery |