The Impact of Prehabilitation

Purpose

While numerous studies have assessed the promising impacts of prehabilitation, there is a lack of prehabilitation research within lower socioeconomic patient populations. Often for prehabilitation studies, patients are heavily involved in full scale exercise and nutrition programs weeks before the scheduled procedure. In underserved populations, programs such as these are often not feasible due to lack of transport, resources, and other barriers to healthcare. The investigators seek to evaluate the effectiveness of inexpensive interventions in lower socioeconomic populations. The investigators hypothesize that barriers to prehabilitation are environmental and that prehabilitation interventions tailored for lower socioeconomic (SES) populations will improve time to discharge, mobility, and in turn, readmission rates. The participants for this clinical trial will be seen four times: initially at the preoperative surgical clinic (6-8 weeks prior to surgery), 1-2 days preop at a pre-procedure clinic, postoperative in the inpatient setting (as soon as the participant is able to ambulate during their hospital stay), and in the postoperative surgical clinic at the postoperative visit. Patients will be within the general surgery, colorectal, and surgical oncology departments at Boston Medical Center (BMC). The anticipated sample size is 60 participants (30 in the intervention/prehabilitation arm and 30 in the control/usual care arm). Participants in the intervention arm will participate in a mobility and step tracking intervention aimed at improving postoperative outcomes. The control group will follow routine standard of care at BMC for preoperative and postoperative care.

Condition

  • Post Operative Complications

Eligibility

Eligible Ages
Between 21 Years and 65 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Patients within general surgery, colorectal, and surgical oncology departments at Boston Medical Center. - English or Spanish speaking - Able to ambulate without cane, walker, wheelchair - Surgery scheduled within 4-8 weeks - Must have cell phone with internet access and text message capabilities - JH-HLM score of 6

Exclusion Criteria

  • Limited/non readers (less than 5th grade reading level), assessed via comprehension of consent materials

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Prevention
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Prehabilitation group
Watch a video created by the investigators, discussing exercise prior to surgery, receive text message reminders to begin exercise before surgery, and take walking tests before and after surgery.
  • Other: Preoperative education
    The intervention will be an instructional video describing proper walking technique particularly up flights of stairs for patients to do at home. This will be shown at preoperative surgical clinic and will be available for access at home from patient's cell phones. The video is currently in production at BMC. Additionally, text reminders will be sent daily to remind patients to walk at home.
  • Behavioral: Moderate aerobic exercise
    Participants will be encouraged to compete 140-150 minutes of moderate aerobic exercise per week- achieved by two walking sessions per day 10-11 minutes in length (realistic/achievable goal)
  • Other: Text messages
    Text reminders will be sent daily to remind patients to walk at home.
  • Behavioral: Pedometer
    Participants will be encouraged to walk 10,000 steps daily which will be tracked with a pedometer
No Intervention
Control group
Receive the usual preoperative and post operative care and they will be provided a pedometer.

Recruiting Locations

Boston Medical Center
Boston, Massachusetts 02118
Contact:
Nicole Spence, MD

More Details

Status
Recruiting
Sponsor
Boston Medical Center

Study Contact

Nicole Spence, MD
617-638-6950
Nicole.Spence@bmc.org