Top

Published in:

Open Access 01-12-2022 | Care | Study protocol

Prehabilitation of elderly frail or pre-frail patients prior to elective surgery (PRAEP-GO): study protocol for a randomized, controlled, outcome assessor-blinded trial

Authors: Stefan J. Schaller, Jörn Kiselev, Verena Loidl, Wilm Quentin, Katrin Schmidt, Rudolf Mörgeli, Tanja Rombey, Reinhard Busse, Ulrich Mansmann, Claudia Spies, on behalf of the PRAEP-GO consortium, , PRAEP-GO investigators

Published in: Trials | Issue 1/2022

Abstract

Background

Frailty is expressed by a reduction in physical capacity, mobility, muscle strength, and endurance. (Pre-)frailty is present in up to 42% of the older surgical population, with an increased risk for peri- and postoperative complications. Consequently, these patients often suffer from a delayed or limited recovery, loss of autonomy and quality of life, and a decrease in functional and cognitive capacities. Since frailty is modifiable, prehabilitation may improve the physiological reserves of patients and reduce the care dependency 12 months after surgery.

Methods

Patients ≥ 70 years old scheduled for elective surgery or intervention will be recruited in this multicenter, randomized controlled study, with a target of 1400 participants with an allocation ratio of 1:1. The intervention consists of (1) a shared decision-making process with the patient, relatives, and an interdisciplinary and interprofessional team and (2) a 3-week multimodal, individualized prehabilitation program including exercise therapy, nutritional intervention, mobility or balance training, and psychosocial interventions and medical assessment. The frequency of the supervised prehabilitation is 5 times/week for 3 weeks. The primary endpoint is defined as the level of care dependency 12 months after surgery or intervention.

Discussion

Prehabilitation has been proven to be effective for different populations, including colorectal, transplant, and cardiac surgery patients. In contrast, evidence for prehabilitation in older, frail patients has not been clearly established. To the best of our knowledge, this is currently the largest prehabilitation study on older people with frailty undergoing general elective surgery.

Trial registration

ClinicalTrials.gov NCT04418271. Registered on 5 June 2020. Universal Trial Number (UTN): U1111-1253-4820

Available only for authorised users

Semel ME, Lipsitz SR, Funk LM, Bader AM, Weiser TG, Gawande AA. Rates and patterns of death after surgery in the United States, 1996 and 2006. Surgery. 2012;151:171–82. https://doi.org/10.1016/j.surg.2011.07.021.CrossRefPubMed

Berian JR, Mohanty S, Ko CY, Rosenthal RA, Robinson TN. Association of loss of independence with readmission and death after discharge in older patients after surgical procedures. JAMA Surg. 2016;151:e161689. https://doi.org/10.1001/jamasurg.2016.1689.CrossRefPubMed

Saczynski JS, Marcantonio ER, Quach L, Fong TG, Gross A, Inouye SK, et al. Cognitive trajectories after postoperative delirium. N Engl J Med. 2012;367:30–9. https://doi.org/10.1056/NEJMoa1112923.CrossRefPubMedPubMedCentral

Govers AC, Buurman BM, Jue P, de Mol BA, Dongelmans DA, de Rooij SE. Functional decline of older patients 1 year after cardiothoracic surgery followed by intensive care admission: a prospective longitudinal cohort study. Age Ageing. 2014;43:575–80. https://doi.org/10.1093/ageing/afu058.CrossRefPubMed

Pisani MA, Albuquerque A, Marcantonio ER, Jones RN, Gou RY, Fong TG, et al. Association between hospital readmission and acute and sustained delays in functional recovery during 18 months after elective surgery: the successful aging after elective surgery study. J Am Geriatr Soc. 2017;65:51–8. https://doi.org/10.1111/jgs.14549.CrossRefPubMed

Martin ET, Kaye KS, Knott C, Nguyen H, Santarossa M, Evans R, et al. Diabetes and risk of surgical site infection: a systematic review and meta-analysis. Infect Control Hosp Epidemiol. 2016;37:88–99. https://doi.org/10.1017/ice.2015.249.CrossRefPubMed

Sibia US, Weltz AS, MacDonald JH, King PJ. Insulin-dependent diabetes is an independent risk factor for complications and readmissions after total joint replacements. J Surg Orthop Adv. 2018;27:294–8.PubMed

Smilowitz NR, Gupta N, Guo Y, Beckman JA, Bangalore S, Berger JS. Trends in cardiovascular risk factor and disease prevalence in patients undergoing non-cardiac surgery. Heart. 2018;104:1180–6. https://doi.org/10.1136/heartjnl-2017-312391.CrossRefPubMed

Watt J, Tricco AC, Talbot-Hamon C, Pham B, Rios P, Grudniewicz A, et al. Identifying older adults at risk of harm following elective surgery: a systematic review and meta-analysis. BMC Med. 2018;16:2. https://doi.org/10.1186/s12916-017-0986-2.CrossRefPubMedPubMedCentral

10.

Birkelbach O, Morgeli R, Spies C, Olbert M, Weiss B, Brauner M, et al. Routine frailty assessment predicts postoperative complications in elderly patients across surgical disciplines - a retrospective observational study. BMC Anesthesiol. 2019;19:204. https://doi.org/10.1186/s12871-019-0880-x.CrossRefPubMedPubMedCentral

11.

Sepehri A, Beggs T, Hassan A, Rigatto C, Shaw-Daigle C, Tangri N, et al. The impact of frailty on outcomes after cardiac surgery: a systematic review. J Thorac Cardiovasc Surg. 2014;148:3110–7. https://doi.org/10.1016/j.jtcvs.2014.07.087.CrossRefPubMed

12.

Lin HS, Watts JN, Peel NM, Hubbard RE. Frailty and post-operative outcomes in older surgical patients: a systematic review. BMC Geriatr. 2016;16:157. https://doi.org/10.1186/s12877-016-0329-8.CrossRefPubMedPubMedCentral

13.

Leung JM, Tsai TL, Sands LP. Brief report: preoperative frailty in older surgical patients is associated with early postoperative delirium. Anesth Analg. 2011;112:1199–201. https://doi.org/10.1213/ANE.0b013e31820c7c06.CrossRefPubMedPubMedCentral

14.

Kim SW, Han HS, Jung HW, Kim KI, Hwang DW, Kang SB, et al. Multidimensional frailty score for the prediction of postoperative mortality risk. JAMA Surg. 2014;149:633–40. https://doi.org/10.1001/jamasurg.2014.241.CrossRefPubMed

15.

Rana MV, Bonasera LK, Bordelon GJ. Pharmacologic considerations of anesthetic agents in geriatric patients. Anesthesiol Clin. 2017;35:259–71. https://doi.org/10.1016/j.anclin.2017.01.011.CrossRefPubMed

16.

Santos-Eggimann B, Cuenoud P, Spagnoli J, Junod J. Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries. J Gerontol A Biol Sci Med Sci. 2009;64:675–81. https://doi.org/10.1093/gerona/glp012.CrossRefPubMed

17.

McIsaac DI, Taljaard M, Bryson GL, Beaule PE, Gagne S, Hamilton G, et al. Frailty as a predictor of death or new disability after surgery: a prospective cohort study. Ann Surg. 2020;271:283–9. https://doi.org/10.1097/SLA.0000000000002967.CrossRefPubMed

18.

Santa Mina D, Clarke H, Ritvo P, Leung YW, Matthew AG, Katz J, et al. Effect of total-body prehabilitation on postoperative outcomes: a systematic review and meta-analysis. Physiotherapy. 2014;100:196–207. https://doi.org/10.1016/j.physio.2013.08.008.CrossRefPubMed

19.

Sanchez-Lorente D, Navarro-Ripoll R, Guzman R, Moises J, Gimeno E, Boada M, et al. Prehabilitation in thoracic surgery. J Thorac Dis. 2018;10:S2593–600. https://doi.org/10.21037/jtd.2018.08.18.CrossRefPubMedPubMedCentral

20.

Gillis C, Buhler K, Bresee L, Carli F, Gramlich L, Culos-Reed N, et al. Effects of nutritional prehabilitation, with and without exercise, on outcomes of patients who undergo colorectal surgery: a systematic review and meta-analysis. Gastroenterology. 2018;155(391-410):e394. https://doi.org/10.1053/j.gastro.2018.05.012.CrossRef

21.

Jahic D, Omerovic D, Tanovic AT, Dzankovic F, Campara MT. The effect of prehabilitation on postoperative outcome in patients following primary total knee arthroplasty. Med Arch. 2018;72:439–43. https://doi.org/10.5455/medarh.2018.72.439-443.CrossRefPubMedPubMedCentral

22.

Moyce Z, Rodseth RN, Biccard BM. The efficacy of peri-operative interventions to decrease postoperative delirium in non-cardiac surgery: a systematic review and meta-analysis. Anaesthesia. 2014;69:259–69. https://doi.org/10.1111/anae.12539.CrossRefPubMed

23.

Deschodt M, Braes T, Flamaing J, Detroyer E, Broos P, Haentjens P, et al. Preventing delirium in older adults with recent hip fracture through multidisciplinary geriatric consultation. J Am Geriatr Soc. 2012;60:733–9. https://doi.org/10.1111/j.1532-5415.2012.03899.x.CrossRefPubMed

24.

Gustafson Y, Brannstrom B, Berggren D, Ragnarsson JI, Sigaard J, Bucht G, et al. A geriatric-anesthesiologic program to reduce acute confusional states in elderly patients treated for femoral neck fractures. J Am Geriatr Soc. 1991;39:655–62. https://doi.org/10.1111/j.1532-5415.1991.tb03618.x.CrossRefPubMed

25.

Friedman SM, Mendelson DA, Bingham KW, Kates SL. Impact of a comanaged geriatric fracture center on short-term hip fracture outcomes. Arch Intern Med. 2009;169:1712–7. https://doi.org/10.1001/archinternmed.2009.321.CrossRefPubMed

26.

Chen H, Li S, Ruan T, Liu L, Fang L. Is it necessary to perform prehabilitation exercise for patients undergoing total knee arthroplasty: meta-analysis of randomized controlled trials. Phys Sportsmed. 2018;46:36–43. https://doi.org/10.1080/00913847.2018.1403274.CrossRefPubMed

27.

McIsaac DI, Gill M, Boland L, Hutton B, Branje K, Shaw J, et al. Prehabilitation in adult patients undergoing surgery: an umbrella review of systematic reviews. Br J Anaesth. 2022;128:244–57. https://doi.org/10.1016/j.bja.2021.11.014.CrossRefPubMed

28.

PRÄPGO. https://www.praep-go.de/. Accessed 01 May 2022.

29.

ClinicalTrials Page of PRÄP-GO. https://clinicaltrials.gov/ct2/show/NCT04418271. Accessed 06 May 2022.

30.

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146–56. https://doi.org/10.1093/gerona/56.3.m146.CrossRefPubMed

31.

Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39:1423–34. https://doi.org/10.1249/mss.0b013e3180616b27.CrossRefPubMed

32.

Stiggelbout AM, Pieterse AH, De Haes JC. Shared decision making: concepts, evidence, and practice. Patient Educ Couns. 2015;98:1172–9. https://doi.org/10.1016/j.pec.2015.06.022.CrossRefPubMed

33.

Kiselev J, Suija K, Oona M, Mellenthin E, Steinhagen-Thiessen E. Patient involvement in geriatric care - results and experiences from a mixed models design study within Project INTEGRATE. Int J Integr Care. 2018;18:12. https://doi.org/10.5334/ijic.2517.CrossRefPubMedPubMedCentral

34.

Pel-Littel RE, Snaterse M, Teppich NM, Buurman BM, van Etten-Jamaludin FS, van Weert JCM, et al. Scholte Op Reimer WJM: Barriers and facilitators for shared decision making in older patients with multiple chronic conditions: a systematic review. BMC Geriatr. 2021;21:112. https://doi.org/10.1186/s12877-021-02050-y.CrossRefPubMedPubMedCentral

35.

Legare F, Stacey D, Pouliot S, Gauvin FP, Desroches S, Kryworuchko J, et al. Interprofessionalism and shared decision-making in primary care: a stepwise approach towards a new model. J Interprof Care. 2011;25:18–25. https://doi.org/10.3109/13561820.2010.490502.CrossRefPubMed

36.

Elwyn G, Durand MA, Song J, Aarts J, Barr PJ, Berger Z, et al. A three-talk model for shared decision making: multistage consultation process. BMJ. 2017;359:j4891. https://doi.org/10.1136/bmj.j4891.CrossRefPubMedPubMedCentral

37.

Elwyn G, Frosch D, Thomson R, Joseph-Williams N, Lloyd A, Kinnersley P, et al. Shared decision making: a model for clinical practice. J Gen Intern Med. 2012;27:1361–7. https://doi.org/10.1007/s11606-012-2077-6.CrossRefPubMedPubMedCentral

38.

American College of Sports M, Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009;41:1510–30. https://doi.org/10.1249/MSS.0b013e3181a0c95c.CrossRef

39.

Izquierdo M, Duque G, Morley JE. Physical activity guidelines for older people: knowledge gaps and future directions. Lancet Healthy Longevity. 2021;2:e380–3. https://doi.org/10.1016/S2666-7568(21)00079-9.CrossRefPubMed

40.

Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39:1435–45. https://doi.org/10.1249/mss.0b013e3180616aa2.CrossRefPubMed

41.

Thomas S, Mackintosh S, Halbert J. Does the ‘Otago exercise programme’ reduce mortality and falls in older adults?: a systematic review and meta-analysis. Age Ageing. 2010;39:681–7. https://doi.org/10.1093/ageing/afq102.CrossRefPubMed

42.

Gschwind YJ, Pfenninger B: Training zur Sturzprävention - Manual für Kraft- und Gleichgewichtstraining zur Sturzprävention im Alter. bfu - Beratungsstelle zur Unfallverhütung. 2016. https://gesundheitsfoerderung.ch/assets/public/documents/de/5-grundlagen/publikationen/gfia/tools/bfu-Fachdokumentation_Training_zur_Sturzpraevention.pdf. Accessed 01 May 2022.

43.

Wingenfeld K, Büscher A, Gansweid B. Das neue Begutachtungsassessment zur Feststellung von Pflegebedürftigkeit: Institut für Pflegewissenschaft an der Universität Bielefeld (IPW)/Medizinischer Dienst der Krankenversicherung Westfalen-Lippe (MDK WL); 2008. https://www.uni-bielefeld.de/gesundhw/ag6/downloads/Abschlussbericht_IPW_MDKWL_25.03.08.pdf. Accessed 01 May 2022

44.

Wingenfeld K, Büschner A, Gansweid B. Das neue Begutachtungsinstrument zur Feststellung von Pflegebedürftigkeit: GKV-Spitzenverband; 2011. https://www.gkv-spitzenverband.de/media/dokumente/service_1/publikationen/schriftenreihe/GKV-Schriftenreihe_Pflege_Band_2_18962.pdf. Accessed 01 May 2022

45.

Bohannon RW, Crouch RH. Two-minute step test of exercise capacity: systematic review of procedures, performance, and clinimetric properties. J Geriatr Phys Ther. 2019;42:105–12. https://doi.org/10.1519/JPT.0000000000000164.CrossRefPubMed

46.

Roberts MH, Mapel DW. Limited lung function: impact of reduced peak expiratory flow on health status, health-care utilization, and expected survival in older adults. Am J Epidemiol. 2012;176:127–34. https://doi.org/10.1093/aje/kwr503.CrossRefPubMedPubMedCentral

47.

Roberts HC, Denison HJ, Martin HJ, Patel HP, Syddall H, Cooper C, et al. A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age Ageing. 2011;40:423–9. https://doi.org/10.1093/ageing/afr051.CrossRefPubMed

48.

Bohannon RW, Wang YC. Four-meter gait speed: normative values and reliability determined for adults participating in the NIH Toolbox Study. Arch Phys Med Rehabil. 2019;100:509–13. https://doi.org/10.1016/j.apmr.2018.06.031.CrossRefPubMed

49.

Hinman MR, O’Connell JK, Dorr M, Hardin R, Tumlinson AB, Varner B. Functional predictors of stair-climbing speed in older adults. J Geriatr Phys Ther. 2014;37:1–6. https://doi.org/10.1519/JPT.0b013e318298969f.CrossRefPubMed

50.

Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142–8.CrossRefPubMed

51.

Taylor JK, Buchan IE, van der Veer SN. Assessing life-space mobility for a more holistic view on wellbeing in geriatric research and clinical practice. Aging Clin Exp Res. 2019;31:439–45. https://doi.org/10.1007/s40520-018-0999-5.CrossRefPubMed

52.

Kroenke K, Spitzer RL, Williams JB, Lowe B. The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen Hosp Psychiatry. 2010;32:345–59. https://doi.org/10.1016/j.genhosppsych.2010.03.006.CrossRefPubMed

53.

Lowe B, Decker O, Muller S, Brahler E, Schellberg D, Herzog W, et al. Validation and standardization of the generalized anxiety disorder screener (GAD-7) in the general population. Med Care. 2008;46:266–74. https://doi.org/10.1097/MLR.0b013e318160d093.CrossRefPubMed

54.

Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179–86.CrossRefPubMed

55.

Seidl H, Bowles D, Bock JO, Brettschneider C, Greiner W, Konig HH, et al. FIMA--questionnaire for health-related resource use in an elderly population: development and pilot study. Gesundheitswesen. 2015;77:46–52. https://doi.org/10.1055/s-0034-1372618.CrossRefPubMed

56.

Seidl H, Hein L, Scholz S, Bowles D, Greiner W, Brettschneider C, et al. Validation of the FIMA Questionnaire for health-related resource use against medical claims data: the role played by length of recall period. Gesundheitswesen. 2021;83:66–74. https://doi.org/10.1055/a-1010-6315.CrossRefPubMed

57.

Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017;17:230. https://doi.org/10.1186/s12877-017-0621-2.CrossRefPubMedPubMedCentral

58.

Charlson M, Wells MT, Ullman R, King F, Shmukler C. The Charlson Comorbidity Index can be used prospectively to identify patients who will incur high future costs. PLoS One. 2014;9:e112479. https://doi.org/10.1371/journal.pone.0112479.CrossRefPubMedPubMedCentral

59.

Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965;14:61–5.PubMed

60.

Brodowski H, Andres N, Gumny M, Eicher C, Steinhagen-Thiessen E, Tannen A, et al. Reliability of stair-climbing speed in two cohorts of older adults. Int J Ther Rehabil. 2021;28:1–15. https://doi.org/10.12968/ijtr.2020.0137.CrossRef

61.

Schepens S, Goldberg A, Wallace M. The short version of the Activities-specific Balance Confidence (ABC) Scale: its validity, reliability, and relationship to balance impairment and falls in older adults. Arch Gerontol Geriatr. 2010;51:9–12. https://doi.org/10.1016/j.archger.2009.06.003.CrossRefPubMed

62.

Borson S, Scanlan J, Brush M, Vitaliano P, Dokmak A. The mini-cog: a cognitive ‘vital signs’ measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry. 2000;15:1021–7.CrossRefPubMed

63.

Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695–9. https://doi.org/10.1111/j.1532-5415.2005.53221.x.CrossRefPubMed

64.

Llinas-Regla J, Vilalta-Franch J, Lopez-Pousa S, Calvo-Perxas L, Torrents Rodas D, Garre-Olmo J. The trail making test. Assessment. 2017;24:183–96. https://doi.org/10.1177/1073191115602552.CrossRefPubMed

65.

Hughes ME, Waite LJ, Hawkley LC, Cacioppo JT. A short scale for measuring loneliness in large surveys: results from two population-based studies. Res Aging. 2004;26:655–72. https://doi.org/10.1177/0164027504268574.CrossRefPubMedPubMedCentral

66.

Garin O, Ayuso-Mateos JL, Almansa J, Nieto M, Chatterji S, Vilagut G, et al. Validation of the “World Health Organization Disability Assessment Schedule, WHODAS-2” in patients with chronic diseases. Health Qual Life Outcomes. 2010;8:51. https://doi.org/10.1186/1477-7525-8-51.CrossRefPubMedPubMedCentral

67.

Nikolaus T, Specht-Leible N, Bach M, Oster P, Schlierf G. Social aspects in diagnosis and therapy of very elderly patients. Initial experiences with a newly developed questionnaire within the scope of geriatric assessment. Z Gerontol. 1994;27:240–5.PubMed

68.

Janssen MF, Pickard AS, Golicki D, Gudex C, Niewada M, Scalone L, et al. Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: a multi-country study. Qual Life Res. 2013;22:1717–27. https://doi.org/10.1007/s11136-012-0322-4.CrossRefPubMed

69.

Nease RF Jr, Brooks WB. Patient desire for information and decision making in health care decisions: the Autonomy Preference Index and the Health Opinion Survey. J Gen Intern Med. 1995;10:593–600. https://doi.org/10.1007/BF02602742.CrossRefPubMed

70.

Doherr H, Christalle E, Kriston L, Harter M, Scholl I. Use of the 9-item Shared Decision Making Questionnaire (SDM-Q-9 and SDM-Q-Doc) in intervention studies-a systematic review. PLoS One. 2017;12:e0173904. https://doi.org/10.1371/journal.pone.0173904.CrossRefPubMedPubMedCentral

71.

Whaley MH, Brubaker PH, Kaminsky LA, Miller CR. Validity of rating of perceived exertion during graded exercise testing in apparently healthy adults and cardiac patients. J Cardpulm Rehabil. 1997;17:261–7. https://doi.org/10.1097/00008483-199707000-00007.CrossRef

72.

Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–81. https://doi.org/10.1016/j.jbi.2008.08.010.CrossRefPubMed

73.

Müller-Mai CM, Schulze Raestrup US, Kostuj T, Dahlhoff G, Günster C, Smektala R. One-year outcomes for proximal femoral fractures: posthospital analysis of mortality and care levels based on health insurance data. Unfallchirurg. 2015;118:780–94. https://doi.org/10.1007/s00113-013-2534-7.CrossRefPubMed

74.

Kolassa JE. A comparison of size and power calculations for the Wilcoxon statistic for ordered categorical data. Stat Med. 1995;14:1577–81.CrossRefPubMed

75.

Hirk R, Hornik K, Vana L. mvord: An R package for fitting multivariate ordinal regression models: Wirtschaftsuniversität Wien; 2017. https://cran.r-project.org/web/packages/mvord/vignettes/vignette_mvord.pdf. Accessed 01 May 2022

76.

Bock JO, Brettschneider C, Seidl H, Bowles D, Holle R, Greiner W, et al. Calculation of standardised unit costs from a societal perspective for health economic evaluation. Gesundheitswesen. 2015;77:53–61. https://doi.org/10.1055/s-0034-1374621.CrossRefPubMed

77.

Defining the role of authors and contributors. http://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html. Accessed 23 Mar 2022.

78.

Wynter-Blyth V, Moorthy K. Prehabilitation: preparing patients for surgery. BMJ. 2017;358:j3702. https://doi.org/10.1136/bmj.j3702.CrossRefPubMed

79.

Le Roy B, Selvy M, Slim K. The concept of prehabilitation: what the surgeon needs to know? J Visc Surg. 2016;153:109–12. https://doi.org/10.1016/j.jviscsurg.2016.01.001.CrossRefPubMed

80.

Hughes MJ, Hackney RJ, Lamb PJ, Wigmore SJ, Christopher Deans DA, Skipworth RJE. Prehabilitation before major abdominal surgery: a systematic review and meta-analysis. World J Surg. 2019;43:1661–8. https://doi.org/10.1007/s00268-019-04950-y.CrossRefPubMed

81.

Hijazi Y, Gondal U, Aziz O. A systematic review of prehabilitation programs in abdominal cancer surgery. Int J Surg. 2017;39:156–62. https://doi.org/10.1016/j.ijsu.2017.01.111.CrossRefPubMed

82.

Moran J, Guinan E, McCormick P, Larkin J, Mockler D, Hussey J, et al. The ability of prehabilitation to influence postoperative outcome after intra-abdominal operation: a systematic review and meta-analysis. Surgery. 2016;160:1189–201. https://doi.org/10.1016/j.surg.2016.05.014.CrossRefPubMed

83.

Gometz A, Maislen D, Youtz C, Kary E, Gometz EL, Sobotka S, et al. The effectiveness of prehabilitation (prehab) in both functional and economic outcomes following spinal surgery: a systematic review. Cureus. 2018;10:e2675. https://doi.org/10.7759/cureus.2675.CrossRefPubMedPubMedCentral

84.

Wallis JA, Taylor NF. Pre-operative interventions (non-surgical and non-pharmacological) for patients with hip or knee osteoarthritis awaiting joint replacement surgery--a systematic review and meta-analysis. Osteoarthr Cartil. 2011;19:1381–95. https://doi.org/10.1016/j.joca.2011.09.001.CrossRef

85.

Vasta S, Papalia R, Torre G, Vorini F, Papalia G, Zampogna B, et al. The influence of preoperative physical activity on postoperative outcomes of knee and hip arthroplasty surgery in the elderly: a systematic review. J Clin Med. 2020;9. https://doi.org/10.3390/jcm9040969.

86.

Milder DA, Pillinger NL, Kam PCA. The role of prehabilitation in frail surgical patients: a systematic review. Acta Anaesthesiol Scand. 2018;62:1356–66. https://doi.org/10.1111/aas.13239.CrossRefPubMed

87.

Baimas-George M, Watson M, Elhage S, Parala-Metz A, Vrochides D, Davis BR. Prehabilitation in frail surgical patients: a systematic review. World J Surg. 2020;44:3668–78. https://doi.org/10.1007/s00268-020-05658-0.CrossRefPubMed

88.

van de Pol MHJ, Fluit C, Lagro J, Slaats Y, Olde Rikkert MGM, Lagro-Janssen ALM. Shared decision making with frail older patients: proposed teaching framework and practice recommendations. Gerontol Geriatr Educ. 2017;38:482–95. https://doi.org/10.1080/02701960.2016.1276014.CrossRefPubMed

89.

Thomson S, Busse R, Crivelli L, van de Ven W, Van de Voorde C. Statutory health insurance competition in Europe: a four-country comparison. Health Policy. 2013;109:209–25. https://doi.org/10.1016/j.healthpol.2013.01.005.CrossRefPubMed

90.

Developments ACotAo, System itHC: Coordination and quality in the health care system. Report 2005. Abridged Version. 2005. https://www.svr-gesundheit.de/fileadmin/Gutachten/Gutachten_2005/Kurzfassung_engl_2005.pdf. Accessed 01 May 2022.

91.

Kimmel A, Reif K, Schiebelhut O, Kowalski I, Brucker U, Breuninger K, et al. Praktikabilitätsstudie zur Einführung des Neuen Begutachtungsassessments zur Feststellung der Pflegebedürftigkeit nach dem SGB XI: Medizinischer Dienst des Spitzenverbandes Bund der Krankenkassen e.V. (MDS); 2015. https://www.gkv-spitzenverband.de/media/dokumente/pflegeversicherung/pflegebeduerftigkeitbegriff/150413_Pflegebegriff_Abschlussbericht_Praktikabilitaetsstudie_Final.pdf. Accessed 01 May 2022

92.

Yamato TP, Maher CG, Saragiotto BT, Hoffmann TC, Moseley AM. How completely are physiotherapy interventions described in reports of randomised trials? Physiotherapy. 2016;102:121–6. https://doi.org/10.1016/j.physio.2016.03.001.CrossRefPubMed

93.

Hariohm K, Jeyanthi S, Kumar JS, Prakash V. Description of interventions is under-reported in physical therapy clinical trials. Braz J Phys Ther. 2017;21:281–6. https://doi.org/10.1016/j.bjpt.2017.05.006.CrossRefPubMedPubMedCentral

94.

McCambridge AB, Nasser AM, Mehta P, Stubbs PW, Verhagen AP. Has reporting on physical therapy interventions improved in 2 decades? An analysis of 140 trials reporting on 225 interventions. J Orthop Sports Phys Ther. 2021;51:503–9. https://doi.org/10.2519/jospt.2021.10642.CrossRefPubMed

Title: Prehabilitation of elderly frail or pre-frail patients prior to elective surgery (PRAEP-GO): study protocol for a randomized, controlled, outcome assessor-blinded trial
Authors: Stefan J. Schaller
Jörn Kiselev
Verena Loidl
Wilm Quentin
Katrin Schmidt
Rudolf Mörgeli
Tanja Rombey
Reinhard Busse
Ulrich Mansmann
Claudia Spies
on behalf of the PRAEP-GO consortium,
PRAEP-GO investigators
Publication date: 01-12-2022
Publisher: BioMed Central
Keyword: Care
Published in: Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI: https://doi.org/10.1186/s13063-022-06401-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prehabilitation of elderly frail or pre-frail patients prior to elective surgery (PRAEP-GO): study protocol for a randomized, controlled, outcome assessor-blinded trial

Abstract

Background

Methods

Discussion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Discussion

Trial registration

Please log in to get access to this content

Other articles of this Issue 1/2022

Effects of acupuncture treatment on postoperative gastrointestinal dysfunction in colorectal cancer: study protocol for randomized controlled trials

Effectiveness of multimodal exercises integrated with cognitive-behavioral therapy in working patients with chronic neck pain: protocol of a randomized controlled trial with 1-year follow-up

Exploring the consequences of food insecurity and harnessing the power of peer navigation and mHealth to reduce food insecurity and cardiometabolic comorbidities among persons with HIV: protocol for development and implementation trial of weCare/Secure

The influence of skin-to-skin contact on Cortical Activity during Painful procedures in preterm infants in the neonatal intensive care unit (iCAP mini): study protocol for a randomized control trial

Efficacy of acupuncture on cognitive function in poststroke depression: study protocol for a randomized, placebo-controlled trial

Efficacy and safety of Sri Lankan traditional medicine regimen for knee osteoarthritis: study protocol for an open-label, active comparator, randomized controlled trial