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Multimodal prehabilitation in people awaiting acute inpatient cardiac surgery: Study protocol for a pilot feasibility trial (PreP-ACe)

Raut, Sarah; Hales, Aaron; Twiddy, Maureen; Dixon, Lili; Ngaage, Dumbor; Yates, David; Danjoux, Gerard; Ingle, Lee

Authors

Sarah Raut

Aaron Hales

Lili Dixon

Dumbor Ngaage

David Yates

Gerard Danjoux

Lee Ingle



Abstract

Background The concept of “prehabilitation,” or optimising individual physical and mental wellbeing prior to surgery is well established in cancer and orthopaedic populations. However, amongst the cardiac surgery population, the concept is relatively new. Of the few studies available, all focus on the elective surgical population. This pilot feasibility trial is novel as it will focus on the impact of multimodal prehabilitation on the acute inpatient cardiac surgical population. Methods This single centre, prospective, single arm pilot feasibility trial will recruit 20 inpatients awaiting cardiac surgery. Measurements will be collected at the start of the trial (baseline), 7 days after intervention, and 14 days after the intervention or before the day of surgery. The primary outcome measure will be feasibility and practicality of the programme in an acute inpatient population. We will be looking into participant eligibility, acceptability, recruitment rates, completion rates and barriers to implementing a prehabilitation programme. Secondary outcomes include incidence of study-related adverse events, improvement in 6 minutes walk test (6MWT), hand grip strength, quality of life, anxiety scores and spirometry. At the end of the trial, we will be seeking the feedback of the participants on key components of the programme to help us inform future work. We hypothesise that light to moderate structured exercise training is low risk and feasible in patients awaiting inpatient cardiac surgery. The study was approved by Health Research Authority and Heath and Care Research Wales (Yorkshire & the Humber- Bradford Leeds Research Ethics Committee: REC reference 23/YH/0255) on the 8th November 2023. Discussion Multimodal prehabilitation could improve individual physical and mental wellbeing whilst awaiting inpatient cardiac surgery. Prehabilitation can provide individuals with a sense of ownership and control over their condition, improve their motivation and independence, and enhance their mental and physical recovery after surgery. Traditionally, patients waiting for cardiac surgery are discouraged from physical activity/ structured exercise training and receive limited information regarding their health. Appropriate physical and psychological support could improve their confidence to mobilise sooner after surgery. This may then facilitate earlier discharge leading to improved hospital bed utilisation and patient flow.

Citation

Raut, S., Hales, A., Twiddy, M., Dixon, L., Ngaage, D., Yates, D., Danjoux, G., & Ingle, L. (2025). Multimodal prehabilitation in people awaiting acute inpatient cardiac surgery: Study protocol for a pilot feasibility trial (PreP-ACe). PLoS ONE, 20(3 March), Article e0307341. https://doi.org/10.1371/journal.pone.0307341

Journal Article Type Article
Acceptance Date Nov 22, 2024
Online Publication Date Mar 10, 2025
Publication Date Mar 1, 2025
Deposit Date Apr 8, 2025
Publicly Available Date Apr 10, 2025
Journal PLoS ONE
Print ISSN 1932-6203
Publisher Public Library of Science
Peer Reviewed Peer Reviewed
Volume 20
Issue 3 March
Article Number e0307341
DOI https://doi.org/10.1371/journal.pone.0307341
Public URL https://hull-repository.worktribe.com/output/5090451

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Publisher Licence URL
http://creativecommons.org/licenses/by/4.0

Copyright Statement
Copyright: © 2025 Raut et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.





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