Home-based prehabilitation with exercise to improve postoperative recovery for older adults with frailty having cancer surgery: the PREHAB randomised clinical trial. McIsaac DI, et al, Br J Anaesth 2022.
- Proposé le : 28/05/2024 04:07:08
- Par : Bot
- Avec la version du site : v2021_01_12
- Revu par :
- Mettre votre nom d'utilisateur
- Mettre votre nom d'utilisateur
Résumé et points clés
Methods: This double blind randomised trial enrolled people ≥60 yr having elective cancer surgery and ≥3 weeks from enrolment to surgery as eligible. Participation in a remotely supported, home-based exercise prehabilitation program plus nutritional guidance was compared with standard care plus written advice on age-appropriate activity and nutrition. The primary outcome was 6-min walk test (6MWT) distance at the first postoperative clinic visit. Secondary outcomes included physical performance, quality of life, disability, length of stay, non-home discharge, and 30-day readmission.
Results: Of 543 patients assessed, 254 were eligible and 204 (80%) were randomised (102 per arm); 182 (94 intervention and 88 control) had surgery and were analysed. Mean age was 74 yr and 57% were female. Mean duration of participation was 5 weeks, mean adherence was 61% (range 0%-100%). We found no significant difference in 6MWT at follow-up (+14 m, 95% confidence interval -26-55 m, P=0.486), or for secondary outcomes. Analyses using a prespecified adherence definition of ≥80% supported improvements in 6MWT distance, complication count, and disability.
Conclusions: A home-based prehabilitation program did not significantly improve postoperative recovery or other outcomes in older adults with frailty having cancer surgery. Program adherence may be a key mediator of prehabilitation efficacy.
Clinical trial registration: NCT02934230.
Références de l'article
Discussion
- Cette section peut être éditée par les relecteurs, les rédacteurs, les modérateurs et les administrateurs. Elle regroupe l'ensemble des échanges autours de la référence ci-dessus présentée.
- Référez-vous à cette page pour connaître le rôle des utilisateurs et pour participer à la discussion.
- Il n'y a, pour l'instant, aucune discussion en cours.