This study aimed to evaluated the interest of a short-term (2 weeks) prehabilitation program compared to no prehabilitation before thoracic or urological surgery
Prehabilitation is a form of global strength training, aims to improve functional capacity before surgery.This preparation compensate for its decrease due to the intervention. This process includes physical training, nutritional and psychological care. Previous studies consider 4 weeks to be the ideal duration time for such program. However, extended program duration may reduce subject compliance and may not be possible for patient who can not or do not want to postponed their surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
* Initial assessment visit with a dietitian, a psychologist, a physiotherapist, a doctor (physical medicine) and a geriatrician (for patients over 75 years old) * Patient will be asked to follow a 2 weeks prehabilitation program * 2 months post-surgery assessment visit with a dietitian, a psychologist, a physiotherapist, a doctor (physical medicine) * 6 months post-surgery assessment visit with a dietitian, a psychologist, a physiotherapist, a doctor (physical medicine)
* Standard care: Initial assessment visit with a dietitian, a psychologist, a physiotherapist, a doctor (physical medicine) and a geriatrician (for patients over 75 years old) * Patients will be asked to maintain regular physical activity without support * 2 months post-surgery assessment visit with a dietitian, a psychologist, a physiotherapist, a doctor (physical medicine) * 6 months post-surgery assessment visit with a dietitian, a psychologist, a physiotherapist, a doctor (physical medicine)
Evaluated the change in physical condition of patient following a short prehabilitation compared to the initial assessment (6 minutes walk test)
Change on the 6-minute walk test (distance covered over a time of 6 minutes in meters)
Time frame: 7 months
Evaluated the change in physical condition of patient following a short prehabilitation compared to the initial assessment (Borg scale)
Change in the Borg scale (exertion from 0 to 10: 0 meaning no exertion, 10 meaning maximal exertion)
Time frame: 7 months
Evaluated the change in cardio-respiratory capacity (VO2 max) of patient following a short prehabilitation at 15 days compared to the initial assessment
VO2 Max Testing, measured in milliliters of oxygen used in one minute per kilogram of body weight (milliliter per kilogram per minute).
Time frame: 15 days
Evaluated the change in cardio-respiratory capacity (spirometry: maximal voluntary ventilation) of patient following a short prehabilitation at 15 days compared to the initial assessment
Evolution of Maximal Voluntary Ventilation (MVV in liter per minute).
Time frame: 15 days
Evaluated the change in cardio-respiratory capacity (spirometry: vital capacity) of patient following a short prehabilitation at 15 days compared to the initial assessment
Evolution of Vital Capacity (VC in liter)
Time frame: 15 days
Evaluated the change in cardio-respiratory capacity (spirometry: functional residual capacity) of patient following a short prehabilitation at 15 days compared to the initial assessment
Evolution of Functional residual capacity (FRC in milliliter per kilogram).
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: 15 days
Evaluated the change in cardio-respiratory capacity (heart rate) of patient following a short prehabilitation at 15 days compared to the initial assessment
Heart rate at 40 watt during a cardiac stress test (beats per minute).
Time frame: 15 days
Evaluated the change in the muscular mass of patient following a short prehabilitation at 15 days compared to the initial assessment
Quadriceps area in square centimeters.
Time frame: 15 days
Evaluated the change in the muscular strength of patient following a short prehabilitation at 15 days compared to the initial assessment
Hand grip Test (measure in Newton).
Time frame: 15 days
Evaluated the change in the body mass (weight) of patient following a short prehabilitation at 15 days compared to the initial assessment
Weight in kilogram.
Time frame: 15 days
Evaluated the change in the body mass (lean mass) of patient following a short prehabilitation at 15 days compared to the initial assessment
Percentage of lean mass.
Time frame: 15 days
Evaluated the change on the psychological state (quality of life) of patient following a short prehabilitation at 15 days compared to the initial assessment
SF-36 quality of life scale (eight health concepts: physical functioning, bodily pain, role limitations due to physical health problems, role limitations due to personal or emotional problems, emotional well-being, social functioning, energy/fatigue, and general health perceptions. Each items are scored on a 0 to 100 range. A high score defines a more favorable health state).
Time frame: 15 days
Evaluated the change on the psychological state (anxiety and depression) of patient following a short prehabilitation at 15 days compared to the initial assessment
Hospital Anxiety and Depression Scale (HADS)(a fourteen item scale that generates : Seven of the items relate to anxiety and seven relate to depression. Each item on the questionnaire is scored from 0-3 and this means that a person can score between 0 and 21 for either anxiety or depression).
Time frame: 15 days
Evaluated the change on the psychological state (fatigue) of patient following a short prehabilitation at 15 days compared to the initial assessment
Patient-Reported Outcomes Measurement Information System (PROMIS) : PROMIS Fatigue-Short Form (seven items that measure both the experience of fatigue and the interference of fatigue on daily activities over the past week on a 5-point Likert scale, ranging from 1 = never to 5 = always).
Time frame: 15 days
Evaluated the change on the psychological state (sleep) of patient following a short prehabilitation at 15 days compared to the initial assessment
Patient-Reported Outcomes Measurement Information System (PROMIS): PROMIS-Sleep Disturbance-Short Form (eight items that measure both the experience problems with sleep and the interference of problems with sleep on daily activities over the past week, ranging from 1 = not at all to 5 = very much).
Time frame: 15 days
Evaluated the change on the psychological state (pain) of patient following a short prehabilitation at 15 days compared to the initial assessment
Patient-Reported Outcomes Measurement Information System (PROMIS): PROMIS Pain Interference - Short Form (six items that measure both the experience of pain and the interference of pain on daily activities over the past week, ranging from 1 = not at all to 5 = very much).
Time frame: 15 days
Evaluated the change on the psychological state (geriatric health) of patient following a short prehabilitation at 15 days compared to the initial assessment
Geriatric health status screening tool (G8 score) (8 questions score between 0 and 17, a higher score indicates a better health status). For geriatric patient only.
Time frame: 15 days
Evaluated the change on the psychological state (daily living) of patient following a short prehabilitation at 15 days compared to the initial assessment
Instrumental activities of daily living scale (8 domains of function ranges from 0 (low function, dependent) to 8 (high function, independent))
Time frame: 15 days
Evaluate compliance to the prehabilitation program
Overall compliance score regarding physical training, proteins intake, well-being and fatigue (complete, partial or non compliance).
Time frame: 15 days
Evaluate post-surgery complications (classification)
Classification of complications according to Dindo and Clavien (grades I, II, IIIa, IIIb, IVa, IVb or V).
Time frame: 2 months and 6 months
Evaluate post-surgery complications (length of stay)
Length of stay in hospital, in intensive care unit or continuous monitoring unit (number of days).
Time frame: 2 months and 6 months
Evaluate post-surgery complications (mortality)
Hospital and 30-day mortality (patient status).
Time frame: 2 months and 6 months
Evaluate post-surgery complications (re-hospitalization)
Re-hospitalization in the same hospital within 30 days of discharge from the initial hospitalization (yes/no).
Time frame: 2 months and 6 months
Evaluate post-surgery complications : comparison between predicted complications and actual complications (ARISCAT)
ARISCAT score (risk of postoperative respiratory complication considered to be low for a score less than 26, moderate for a score of 26 to 44, and high for a score of 45 or more).
Time frame: 2 months and 6 months
Evaluate post-surgery complications : comparison between predicted complications and actual complications (LEE)
LEE score (postoperative cardiac risk (infarction, heart failure, death): 0-1 low risk, 2 significant risk, more than 3 major risk).
Time frame: 2 months and 6 months
Evaluate post-surgery complications : comparison between predicted complications and actual complications (POSPOM)
Preoperative Score To Predict Postoperative Mortality (POSPOM) system (scale of 0 to 50 points, with 0 given to patients with the lowest risk).
Time frame: 2 months and 6 months
Evaluate post-surgery complications : comparison between predicted complications and actual complications (Charlson index)
Charlson index (22 conditions are assigned a score of 1, 2, 3, or 6, depending on the risk of dying associated with each one. Scores are summed to provide a total score to predict mortality. A higher score indicates a higher risk of mortality.)
Time frame: 2 months and 6 months
Evaluate post-surgery complications : comparison between predicted complications and actual complications (POSSUM score)
Physiologic and Operative Severity Score for the enUmeration of Mortality and Morbidity score (POSSUM score) (18 factors scored exponentially increasing from 1 to 8. A higher score indicates a higher risk of mortality).
Time frame: 2 months and 6 months
Evaluated the change in cardio-respiratory capacity (6 minutes walk test) of patient following a short prehabilitation at 2 and 6 months compared to the initial assessment
Change on the 6-minute walk test (distance covered over a time of 6 minutes in meters).
Time frame: 2 months and 6 months
Evaluated the change in cardio-respiratory capacity (VO2 max) of patient following a short prehabilitation at 2 and 6 months compared to the initial assessment
VO2 Max Testing, measured in milliliters of oxygen used in one minute per kilogram of body weight (milliliter per kilogram per minute).
Time frame: 2 months and 6 months
Evaluated the change in cardio-respiratory capacity (spirometry: maximal voluntary ventilation) of patient following a short prehabilitation at 2 and 6 months compared to the initial assessment
Evolution of Maximal Voluntary Ventilation (MVV in liter per minute).
Time frame: 2 months and 6 months
Evaluated the change in cardio-respiratory capacity (spirometry: vital capacity) of patient following a short prehabilitation at 2 and 6 months compared to the initial assessment
Evolution of Vital Capacity (VC in liter).
Time frame: 2 months and 6 months
Evaluated the change in cardio-respiratory capacity (spirometry: functional residual capacity) of patient following a short prehabilitation at 2 and 6 months compared to the initial assessment
Evolution of Functional residual capacity (FRC in milliliter per kilogram).
Time frame: 2 months and 6 months
Evaluated the change in cardio-respiratory capacity (heart rate) of patient following a short prehabilitation at 2 and 6 months compared to the initial assessment
Heart rate at 40 watt during a cardiac stress test (beats per minute).
Time frame: 2 months and 6 months
Evaluated the change in the muscular mass of patient following a short prehabilitation at 2 and 6 months compared to the initial assessment
Quadriceps area in square centimeters.
Time frame: 2 months and 6 months
Evaluated the change in the muscular strength of patient following a short prehabilitation at 2 and 6 months compared to the initial assessment
Hand grip Test (measure in Newton).
Time frame: 2 months and 6 months
Evaluated the change in the body mass (weight) of patient following a short prehabilitation at 2 and 6 months compared to the initial assessment
Weight in kilogram.
Time frame: 2 months and 6 months
Evaluated the change in the body mass (lean mass) of patient following a short prehabilitation at 2 and 6 months compared to the initial assessment
Percentage of lean mass.
Time frame: 2 months and 6 months
Evaluated the change on the psychological state (quality of life) of patient following a short prehabilitation at 2 and 6 months compared to the initial assessment
SF-36 quality of life scale (eight health concepts: physical functioning, bodily pain, role limitations due to physical health problems, role limitations due to personal or emotional problems, emotional well-being, social functioning, energy/fatigue, and general health perceptions. Each items are scored on a 0 to 100 range. A high score defines a more favorable health state).
Time frame: 2 months and 6 months
Evaluated the change on the psychological state (anxiety and depression) of patient following a short prehabilitation at 2 and 6 months compared to the initial assessment
Hospital Anxiety and Depression Scale (HADS) (a fourteen item scale that generates : Seven of the items relate to anxiety and seven relate to depression. Each item on the questionnaire is scored from 0-3 and this means that a person can score between 0 and 21 for either anxiety or depression).
Time frame: 2 months and 6 months
Evaluated the change on the psychological state (fatigue) of patient following a short prehabilitation at 2 and 6 months compared to the initial assessment
Patient-Reported Outcomes Measurement Information System (PROMIS) : PROMIS Fatigue-Short Form (seven items that measure both the experience of fatigue and the interference of fatigue on daily activities over the past week on a 5-point Likert scale, ranging from 1 = never to 5 = always).
Time frame: 2 months and 6 months
Evaluated the change on the psychological state (sleep) of patient following a short prehabilitation at 2 and 6 months compared to the initial assessment
Patient-Reported Outcomes Measurement Information System (PROMIS): PROMIS-Sleep Disturbance-Short Form (eight items that measure both the experience problems with sleep and the interference of problems with sleep on daily activities over the past week, ranging from 1 = not at all to 5 = very much)
Time frame: 2 months and 6 months
Evaluated the change on the psychological state (pain) of patient following a short prehabilitation at 2 and 6 months compared to the initial assessment
Patient-Reported Outcomes Measurement Information System (PROMIS): PROMIS Pain Interference - Short Form (six items that measure both the experience of pain and the interference of pain on daily activities over the past week, ranging from 1 = not at all to 5 = very much).
Time frame: 2 months and 6 months
Evaluated the change on the psychological state (geriatric health) of patient following a short prehabilitation at 2 and 6 months compared to the initial assessment
Geriatric health status screening tool (G8 score) (8 questions score between 0 and 17, a higher score indicates a better health status). For geriatric patient only.
Time frame: 2 months and 6 months
Evaluated the change on the psychological state (daily living) of patient following a short prehabilitation at 2 and 6 months compared to the initial assessment
Instrumental activities of daily living scale (8 domains of function ranges from 0 (low function, dependent) to 8 (high function, independent)).
Time frame: 2 months and 6 months
Evaluated the compliance to the prehabilitation program
Overall compliance score regarding physical training, proteins intake, well-being and fatigue (complete, partial or non compliance)
Time frame: 2 months and 6 months