Evidence map›Paper›PMID 42414962›Full record

Trial reportBMC geriatrics2026

Inspiratory muscle training as part of multimodal prehabilitation improves maximal inspiratory pressure in elderly surgical patients: an exploratory secondary analysis of a randomised controlled trial.

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

Registry-linked trialAbstract readEquivalence TrialRandomized Controlled Trial
In one paragraph

Trial report in BMC geriatrics, 2026. 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. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

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

Funding

Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung FNSNF 33IC30_201298 / 1
6 · The paper itself

Abstract

backgroundOlder adults awaiting major surgery often present with reduced physical fitness and respiratory muscle weakness, which are associated with increased postoperative complications. Prehabilitation may improve functional capacity, but evidence for its effect on inspiratory muscle strength in high-risk older adults remains limited. The main objective was to assess the change in maximal inspiratory pressure (MIP) in the preoperative period in high-risk patients receiving home-based tele-supervised prehabilitation compared to standard care.

methodsThis exploratory analysis included a subset of secondary outcome data from a prospective, two-arm, parallel-group randomised controlled trial conducted at a single university hospital in Switzerland. Patients aged ≥ 65 years awaiting elective cardiac or major non-cardiac surgery with a proven fitness deficit measured by cardiopulmonary exercise testing (CPET) were included. Participants randomized in the intervention arm received a multimodal, home-based tele-supervised prehabilitation programme over 2-4 weeks addressing deficits in physical fitness, nutrition, and anaemia, while controls received standard preoperative care.

resultsEighty eight participants were analysed (intervention n = 48; control n = 40). Patients in the intervention group showed improvement in MIP after the training period, whereas the control group demonstrated a decline (median change + 10.5 [0.00; 16.2] vs. - 3.00 [-8.00; 1.50] cmH₂O; p < 0.001). After adjustment for baseline MIP, the estimated between-group difference was 13.39 cmH₂O (95%CI 8.12-18.75; p < 0.001).

conclusionsHome-based tele-supervised IMT, delivered as part of a multimodal prehabilitation programme, improved maximal inspiratory pressure over the preoperative period in elderly high-risk surgical patients. The observed MIP decline in the control group suggests that the preoperative waiting period itself may carry a risk of functional deterioration in this population. Whether MIP improvements translate into reduced postoperative morbidity will be addressed by the primary outcome of the ongoing PREHABIL trial.

trial registrationClinicalTrials.gov Identifier NCT04461301 (First Submitted: 02.07.2020, First Posted: 08.07.2020).

Indexed as

Breathing ExercisesMaximal Respiratory PressuresPreoperative CarePreoperative ExerciseRespiratory MusclesAgedAged, 80 and overFemaleHumansMaleMuscle StrengthProspective StudiesElderlyInspiratory muscle trainingMaximal inspiratory pressurePrehabilitationTelemedicine

Identifiers

PMID42414962
PMCPMC13629078

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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.