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From Prehabilitation to Rehabilitation (Prehab2Rehab): Digitally Supported Short-Term Prehabilitation Prior to Cardiac Surgery (Prehab2Rehab)

From Prehabilitation to Rehabilitation (Prehab2Rehab): Digitally Supported Short-Term Prehabilitation Prior to Cardiac Surgery - A Prospective Observational Feasibility Trial

Prehab2Rehab is a prospective single-arm feasibility study evaluating the implementation of a multimodal, digitally supported prehabilitation program for adults awaiting elective cardiac surgery. During the routine preoperative waiting period, participants receive individualized education, psychosocial support, nutritional counselling, home-based physical activity guidance, and digital self-management support. The study aims to determine the feasibility, acceptability, usability, and safety of integrating this multidisciplinary prehabilitation pathway into routine clinical care. Exploratory outcomes include functional capacity, psychological well-being, nutritional status, digital engagement, and selected perioperative clinical outcomes to inform the design of future confirmatory trials.

Panoramica dello studio

Stato

Non ancora reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

Background

Patients awaiting elective cardiac surgery frequently experience reduced physical capacity, psychological distress, and modifiable lifestyle-related risk factors that may negatively influence perioperative recovery. While advances in cardiac surgery have substantially improved survival, optimizing patients' physical and psychological condition before surgery has become an increasingly important component of perioperative care.

Multimodal prehabilitation has shown promising results in several surgical populations by combining exercise, nutritional support, psychological interventions, and patient education. However, structured prehabilitation programs are not routinely implemented in Austria because of organizational, logistical, and resource-related barriers. Digital health technologies provide an opportunity to integrate multidisciplinary prehabilitation into existing clinical pathways while minimizing disruption to routine care.

The Prehab2Rehab project was developed to establish an integrated, digitally supported care pathway that connects the preoperative waiting period with postoperative rehabilitation. Rather than replacing routine care, the intervention complements existing clinical services by providing structured support before surgery and facilitating patient engagement throughout the perioperative pathway.

Study Design

This prospective, single-arm observational feasibility study will be conducted at the Vienna General Hospital (Medical University of Vienna). Approximately 40 adults scheduled for elective low-risk cardiac surgery (NYHA class I-II) will participate in a multimodal prehabilitation program delivered during the routine preoperative waiting period of approximately 6-10 weeks.

The primary objective is to evaluate the feasibility of implementing the intervention in routine clinical practice. Feasibility outcomes include recruitment and retention, adherence to intervention components, completeness of data collection, usability and acceptability of the digital support tools, and intervention safety.

Secondary exploratory analyses will estimate within-group changes in functional performance, psychological well-being, nutritional status, health-related quality of life, and selected perioperative clinical outcomes. These data will be used to estimate effect sizes and inform the design of future randomized controlled trials.

Intervention

The Prehab2Rehab intervention is a personalized, multimodal prehabilitation program integrated into routine perioperative care. It includes:

structured patient education regarding surgery, recovery, and self-management, psychosocial support focusing on stress management, coping strategies, motivation, and self-efficacy, nutritional assessment and individualized nutritional counselling, individualized home-based physical activity guidance, including aerobic exercise, resistance exercises, breathing exercises, and inspiratory muscle training, digital support for education, communication, activity documentation, and care coordination through study-specific digital platforms.

The intervention is individualized according to participants' clinical status and preferences and is delivered by a multidisciplinary team including physicians, psychologists, dietitians, physiotherapists/sports scientists, and study staff. Participation in the study does not alter routine surgical management or postoperative rehabilitation.

Assessments

Participants are assessed at baseline before prehabilitation, immediately before surgery, and after completion of structured Phase II cardiac rehabilitation. Assessments include measures of functional capacity, nutritional status, patient-reported outcomes, digital engagement, intervention adherence, safety, and routinely collected perioperative clinical outcomes. In addition, semi-structured qualitative interviews with patients and healthcare professionals will explore acceptability, user experiences, implementation barriers, and facilitators to support future implementation in routine clinical practice.

Tipo di studio

Interventistico

Iscrizione (Stimato)

40

Fase

  • Non applicabile

Contatti e Sedi

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Contatto studio

Backup dei contatti dello studio

Luoghi di studio

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Adulto
  • Adulto più anziano

Accetta volontari sani

No

Descrizione

Inclusion Criteria:

- Age ≥ 18 years

  • Classification as New York Heart Association (NYHA) functional class I-II
  • Low surgical risk profile, defined as a EuroSCORE between 0 and 3
  • Scheduled for one of the following elective cardiac surgical procedures:

    • Open-heart valve surgery
    • Coronary artery bypass grafting (CABG)
    • Combined valve surgery and CABG
    • Surgical closure of an atrial septal defect (ASD)
  • Primary residence in Vienna to ensure the feasibility of in-person assessments and supervised sessions
  • Sufficient German language proficiency to participate in assessments and educational components
  • Adequate digital literacy to engage with the digital support tools used in the intervention
  • Clinical and physical assessment confirming that participation in exercise training is medically safe

Exclusion Criteria:

  • Emergency, urgent, or otherwise non-elective cardiac surgery
  • Highly complex or specialized surgical procedures (e.g., aortic aneurysm repair, cardiac tumor resections)
  • Interventional cardiac procedures (e.g., transcatheter aortic valve implantation [TAVI], MitraClip interventions)
  • Neuromotor or physical impairments that might prevent adherence to the study protocol or informed participation
  • Contraindications to spiroergometry according to current guidelines:

Absolute contraindications:

  • Acute coronary syndrome
  • Symptomatic cardiac arrhythmias and/or hemodynamic instability
  • Decompensated heart failure
  • Acute pulmonary embolism
  • Acute endocarditis, myocarditis, or pericarditis
  • Febrile infections
  • Acute deep vein thrombosis of the lower extremities

Relative contraindications:

  • Left main coronary artery stenosis
  • Electrolyte imbalances
  • Arterial hypertension (>160 mmHg systolic)
  • Tachyarrhythmias
  • Hypertrophic obstructive cardiomyopathy (HOCM)
  • High-grade atrioventricular block
  • Anemia
  • Physical or psychological impairments

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Altro
  • Assegnazione: N / A
  • Modello interventistico: Assegnazione di gruppo singolo
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Digitally Supported Prehabilitation
Participants receive a personalized, multimodal, digitally supported prehabilitation program during the routine preoperative waiting period before elective cardiac surgery. The program includes patient education, psychosocial support, nutritional counselling, individualized home-based physical activity guidance, and digital self-management support in addition to routine clinical care.
The Prehab2Rehab intervention is a personalized, multimodal, digitally supported prehabilitation program delivered during the routine 6-10 week preoperative waiting period before elective cardiac surgery. The program includes structured patient education, psychosocial support, nutritional assessment and counselling, individualized home-based physical activity guidance (including aerobic exercise, resistance training, breathing exercises, and inspiratory muscle training), and digital tools to support education, communication, self-management, and documentation. The intervention is delivered by a multidisciplinary team and complements routine perioperative care without altering standard clinical management.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Proportion of eligible patients providing written informed consent (Recruitment rate)
Lasso di tempo: From study initiation until completion of recruitment (approximately 6 months)
Proportion of eligible patients who provide written informed consent and are enrolled in the study.
From study initiation until completion of recruitment (approximately 6 months)
Proportion of enrolled participants completing the study (Participant retention)
Lasso di tempo: From baseline until completion of follow-up after Phase II cardiac rehabilitation (approximately 4-6 months)
Proportion of enrolled participants who complete the prehabilitation program and scheduled study assessments through follow-up.
From baseline until completion of follow-up after Phase II cardiac rehabilitation (approximately 4-6 months)
Proportion of completed intervention components (Adherence to the prehabilitation program)
Lasso di tempo: Throughout the preoperative intervention period (approximately 6-10 weeks)
Participant adherence to the planned intervention components, including educational sessions, psychosocial support, nutritional counselling, home-based physical activity guidance, and use of digital support tools, assessed using attendance records and digital activity logs.
Throughout the preoperative intervention period (approximately 6-10 weeks)
Proportion of completed study assessments and available study data (Data completeness)
Lasso di tempo: From baseline until completion of follow-up after Phase II cardiac rehabilitation (approximately 4-6 months)
Proportion of planned study assessments, questionnaires, and clinical data successfully completed at each scheduled assessment time point.
From baseline until completion of follow-up after Phase II cardiac rehabilitation (approximately 4-6 months)
Participant-reported usability and acceptability scores for the digital support tools
Lasso di tempo: At the preoperative assessment following completion of the prehabilitation program (approximately 6-10 weeks after baseline)
Participant-reported usability and acceptability of the digital applications used during the prehabilitation program, assessed using a study-specific evaluation questionnaire and digital usage metrics.
At the preoperative assessment following completion of the prehabilitation program (approximately 6-10 weeks after baseline)
Number, severity, and type of intervention-related adverse events
Lasso di tempo: From enrolment until completion of the prehabilitation program (approximately 6-10 weeks)
Number, severity, and type of intervention-related adverse events occurring during participation in the prehabilitation program.
From enrolment until completion of the prehabilitation program (approximately 6-10 weeks)

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Collaboratori

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

1 agosto 2026

Completamento primario (Stimato)

30 aprile 2027

Completamento dello studio (Stimato)

31 ottobre 2027

Date di iscrizione allo studio

Primo inviato

16 luglio 2026

Primo inviato che soddisfa i criteri di controllo qualità

16 luglio 2026

Primo Inserito (Effettivo)

21 luglio 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

24 luglio 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

23 luglio 2026

Ultimo verificato

1 luglio 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • Prehab2Rehab_CardiacSurgery

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Descrizione del piano IPD

Individual participant data will not be made publicly available because of privacy and data protection regulations (GDPR) and the small sample size, which may increase the risk of participant identification. Aggregated study results will be reported in scientific publications.

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .