Wearable-Supported Prehabilitation and Rehabilitation for Patients Undergoing Surgery for Pancreatic Cancer

Overview

The goal of this clinical trial is to evaluate whether a wearable-enabled prehabilitation and rehabilitation pathway can improve recovery and post-operative outcomes in adults undergoing surgery for pancreatic cancer or related pancreatic/periampullary conditions. The main questions it aims to answer are: Does a wearable-enabled prehabilitation and rehabilitation programme reduce post-operative complications within 30 and 90 days after surgery? Is the use of wearable devices and remote monitoring feasible, acceptable, and useful for patients and healthcare professionals during the perioperative pathway? Researchers will compare patients receiving the wearable-enabled pathway with a matched historical control group who received standard care to determine whether the intervention is associated with improved surgical and recovery outcomes. Participants will: Provide informed consent and complete baseline assessments and questionnaires. Take part in the Greater Manchester Prehab4Cancer programme before surgery, including personalised exercise, nutritional support, and wellbeing support. Wear a Corsano CardioWatch device to continuously monitor physiological and activity data. Use home monitoring equipment, including weight scales and blood pressure monitoring devices. Complete questionnaires and participant logs during prehabilitation and recovery. Receive regular support from the research team during participation. Undergo pancreatic surgery and receive standard NHS perioperative care. Continue wearable monitoring and rehabilitation after hospital discharge. Be followed for up to 12 months after surgery using routine clinical data to assess recovery, complications, hospital utilisation, and survival. Optionally participate in a focus group to discuss their experiences of wearable-enabled care.

POWR-PaC (Perioperative Optimisation and Wearable Remote monitoring of Pancreatic Cancer) is a prospective, single-centre study evaluating the integration of wearable technologies into an established perioperative prehabilitation and rehabilitation pathway for patients undergoing pancreatic surgery. The study is being conducted at Manchester University NHS Foundation Trust in partnership with the Greater Manchester Prehab4Cancer programme. Major pancreatic surgery is associated with substantial morbidity, prolonged recovery, and significant variation in patient outcomes. Although prehabilitation programmes have demonstrated benefits for physical fitness and surgical preparedness, there is limited evidence regarding the role of continuous physiological monitoring and remote assessment throughout the perioperative pathway. Wearable technologies may provide objective, longitudinal measures of activity, sleep, cardiovascular function, recovery trajectories, and treatment tolerance that are not routinely captured during standard care. Participants enrolled in the intervention arm will be prescribed the targeted Greater Manchester Prehab4Cancer pathway and will additionally receive a wearable monitoring package consisting of a Corsano CardioWatch device and supporting home monitoring equipment. Physiological and behavioural measures collected by the wearable system may include physical activity, heart rate, respiratory rate, oxygen saturation, skin temperature, sleep-related metrics, and other device-derived indicators. Weight and blood pressure measurements will also be collected using home monitoring equipment where applicable. Data collection will occur across the perioperative pathway, including the pre-operative prehabilitation period, inpatient surgical admission, and post-operative rehabilitation phase. Clinical, functional, physiological, and patient-reported outcome measures will be collected alongside routinely recorded healthcare data. The study will evaluate data completeness, participant adherence, acceptability of remote monitoring, and the potential relationship between wearable-derived metrics and clinical outcomes. A matched historical control cohort will be identified from electronic health records at Manchester University NHS Foundation Trust. Control participants will have undergone pancreatic surgery and standard perioperative care without participation in the wearable-enabled pathway. Matching methods will be used to minimise baseline differences between groups and support comparative analyses of clinical outcomes. The primary clinical evaluation will focus on post-operative morbidity within 30 and 90 days of surgery. Secondary analyses will assess measures including mortality, hospital utilisation, days alive and out of hospital, functional recovery, quality of life, and engagement with prehabilitation and rehabilitation services. Exploratory analyses will investigate whether longitudinal wearable data can provide early indicators of recovery status, post-operative complications, or treatment response. The study also incorporates a mixed-methods evaluation of implementation. Participants, healthcare professionals, and exercise specialists may be invited to take part in qualitative focus groups to explore experiences of wearable-supported care, barriers and facilitators to adoption, usability of the technology, and opportunities for future pathway optimisation. Qualitative findings will be used to inform the future design, implementation, and scale-up of digitally enabled perioperative pathways within NHS surgical services. The findings from POWR-PaC will provide evidence regarding the feasibility, acceptability, and potential clinical value of integrating wearable technologies into perioperative cancer care and will inform the development of larger effectiveness studies and future digitally enabled surgical pathways.