Journal Article

The protocol for the prehabilitation for thoracic surgery study: a randomized pragmatic trial comparing a short home-based multimodal program to aerobic training in patients undergoing video-assisted thoracoscopic surgery lobectomy

Zhang, Yuelun, Liu, Zijia, Cui, Yushang, Pei, Lijian, Liu, Yuchao, Huang, Yuguang

2023

Overview

Background Prehabilitation has been shown to have a positive effect on the postoperative recovery of functional capacity in patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy. The optimal way to implement prehabilitation programs, such as the optimal forms of prehabilitation, duration, intensity, and methods to improve compliance, remained to be studied. This Prehabilitation for Thoracic Surgery Study will compare the effectiveness of multimodal and aerobic training-only programs in patients undergoing thoracoscopic lobectomy. Methods This randomized pragmatic trial will be conducted in Peking Union Medical College Hospital (PUMCH) and include 100 patients who are eligible to undergo VATS lobectomy. Patients will be randomized to a multimodal or aerobic training group. Prehabilitation training guidance will be provided by a multidisciplinary care team. The patients in the multimodal group will perform aerobic exercises, resistance exercises, breathing exercises, psychological improvement strategies, and nutritional supplementation. Meanwhile, the patients in the aerobic group will conduct only aerobic exercises. The interventions will be home-based and supervised by medical providers. The patients will be followed up until 30 days after surgery to investigate whether the multimodal prehabilitation program differs from the aerobic training program in terms of the magnitude of improvement in functional capability pre- to postoperatively. The primary outcome will be the perioperative 6-min walk distance (6MWD). The secondary outcomes will include the postoperative pulmonary functional recovery status, health-related quality of life score, incidence of postoperative complications, and clinical outcomes. Discussion Prehabilitation remains a relatively new approach that is not widely performed by thoracic surgery patients. The existing studies mainly focus on unimodal interventions. While multimodal prehabilitation strategies have been shown to be preferable to unimodal strategies in a few studies, the evidence remains scarce for thoracic surgery patients. The results of this study will contribute to the understanding of methods for thoracoscopic lobectomy patients. Trial registration ClinicalTrials.gov NCT04049942 . Registered on August 8, 2019.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Aerobic training / Aerobics / Anesthesia / Biomedicine / Care and treatment / Chest / Clinical trials / Dietary supplements / Exercise / Exercise Therapy - adverse effects / Fitness training programs / Functional capacity / Gastrointestinal surgery / Health Sciences / Hospitals / Humans / Intervention / Laboratories / Lobectomy / Lung cancer / Lymph nodes / Medical personnel / Medicine / Medicine & Public Health / Multimodal prehabilitation / Patients / Physical fitness / Postoperative Complications - epidemiology / Postoperative Complications - etiology / Postoperative Complications - prevention & control / Pragmatic Clinical Trials as Topic / Pragmatic trial / Preoperative Exercise / Proteins / Quality of Life / Randomized Controlled Trials as Topic / Schedules / Statistics for Life Sciences / Study Protocol / Surgery / The future of pragmatic trials / Thoracic Surgery / Thoracic Surgery, Video-Assisted - adverse effects / Video-assisted thoracoscopic surgeries