Evidence map›Paper›PMID 40615882›Full record

ArticlePerioperative medicine (London, England)2025

Effect of multimodal home-based prehabilitation on objectively measured physical activity in patients undergoing elective cardiac or non-cardiac major surgery: secondary outcomes from a randomised controlled trial.

Thomas Vetsch, Simone Wen-Shi Dueblin, Prisca Eser, Christian M Beilstein, Patrick Y Wuethrich, Matthias Wilhelm, Dominque Engel

Registry-linked trialAbstract read
In one paragraph

Article in Perioperative medicine (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04461301 (Multimodal Prehabilitation for Major Surgery in Elderly Patients to Lower Complications and to Increase Cost Effectiveness), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04461301 narecruitingnot on this map

Multimodal Prehabilitation for Major Surgery in Elderly Patients to Lower Complications and to Increase Cost Effectiveness: a Randomised, Prospective, Multicenter, Multidisciplinary Trial (PREHABIL Trial).

TypeinterventionalSponsorInsel Gruppe AG, University Hospital BernRan2022 to 2026Enrolled466ConditionsFrail Elderly Syndrome, Major SurgeryArmsMultimodal Prehabilitation
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Thomas VetschDepartment of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, CH-3010, Switzerland. thomas.vetsch@insel.ch.ORCID http://orcid.org/0000-0002-4231-7837
Simone Wen-Shi DueblinDepartment of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, CH-3010, Switzerland.ORCID http://orcid.org/0009-0009-4684-6304
Prisca EserCentre for Rehabilitation & Sports Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0001-9734-0682
Christian M BeilsteinDepartment of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, CH-3010, Switzerland.ORCID http://orcid.org/0000-0002-1366-2949
Patrick Y WuethrichDepartment of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, CH-3010, Switzerland.ORCID http://orcid.org/0000-0003-3704-6785
Matthias WilhelmCentre for Rehabilitation & Sports Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0003-4541-3995
Dominque EngelDepartment of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, CH-3010, Switzerland.ORCID http://orcid.org/0000-0003-0544-7170

Funding

Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung 33IC30_201298
6 · The paper itself

Abstract

objectiveTo assess physical activity (PA) measured in steps per day in the preoperative period in high-risk cardiac and non-cardiac surgical patients receiving home-based tele-supervised prehabilitation compared to standard of care and to compare steps per day with raw acceleration metrics. STUDY

designIt is an analysis of secondary outcome data of a prospective, two-arm parallel group, randomised controlled trial.

settingIt is a single university hospital in Switzerland.

participantsThese are patients ≥ 65 years awaiting elective cardiac or non-cardiac major surgery with a proven fitness deficit measured by a cardiopulmonary exercise test (CPET). Analysis of PA data after successfully enrolling 200 patients (167 with complete data) in the trial. Average age was 73.8 years (SD 5.3) in cardiac and 76.0 years (SD 6) in non-cardiac patients.

interventionThe intervention arm consists of a multimodal, home-based tele-supervised prehabilitation programme over 2-4 weeks addressing deficits in physical fitness, nutrition, and preoperative anaemia. PRIMARY OUTCOME: Steps per day are assessed by an open-source algorithm from wrist-worn accelerometer data. SECONDARY OUTCOME: Raw acceleration as overall Euclidean Norm Minus One (ENMO) is expressed in milligravitational units (mg).

resultsNon-cardiac (n = 107) patients had more steps per day in the intervention group versus standard of care (4662 [2817; 6807] vs 3378 [1919; 4831], p = 0.042). Overall, ENMO was higher in the intervention group but not statistically significant. No significant differences in PA measures were observed between randomisation groups in cardiac (n = 60) patients. Cardiac patients had overall higher PA levels and were younger than non-cardiac. The difference remained after adjusting for age. Steps per day correlated strongly with overall ENMO.

conclusionSimple preoperative PA recommendations effectively improve steps per day in high-risk non-cardiac surgery patients. To detect changes in PA in the high-risk surgical patient, steps per day can be used as an intuitive measure. To compare with other populations, overall ENMO is preferable. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Identifier: NCT04461301.

Indexed as

AccelerometerPhysical activityPrehabilitationTelemedicine

Identifiers

PMID40615882
PMCPMC12228390

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.