PREPARE study

Rationale: In the past decade, (complex) abdominal wall reconstructions (AWR) are advanced. More patients are eligible for this major elective abdominal wall surgery. The population undergoing an AWR tend to have significant associated, multiple comorbidities, complicating the recovery of a reconstruction. Undergoing AWR exposes these patients to a risk for respiratory complications, which is common after AWR. These complications are associated with an increased surgical morbidity and mortality, prolonged hospital stay, an additional cost burden and indirectly a decrease in quality of life. Improving the physical capacity before surgery, by preoperative exercise therapy (PexT), is likely to give a better recovery and lower complication rate after surgery. In this study, we will survey the feasibility of PexT in patients undergoing an AWR. Outcome measures will be added to demonstrate a possible effect of PexT.

Objective: Primary: Demonstrate the feasibility of PexT in patients waiting for AWR.

Secondary: Demonstrate a possible effect of PexT in patient waiting for AWR on physical capacity (VO2max) and health-related quality of life (HRQL).

Study design: Feasibility study.

Study population: Patients undergoing an abdominal wall reconstruction.

Intervention: The study group will have PExT, consisting of cardiovascular-, strength and respiratory muscle training, for at least 3 months before surgery.

Main study parameters/endpoints: Primary endpoint is feasibility, based on the participants ability to complete the program and any adverse events or injuries occurred during PexT. Secondary endpoints are VO2max and HRQL.

Preoperative exercise therapy is feasible in patients before complex abdominal wall reconstruction.

Time Test

T0:

- Baseline characteristics

- VO2max

- HRQL

T1:

- Feasibility

- VO2max

T2:

- PCR

- LOHS

T3:

- VO2max

- HRQL

T4:

- HRQL

The PexT intervention consists of:

1) Information about the benefits of PexT on the physical capacity and encouragement to adhere to the intervention.

2) Respiratory muscle training

3) Three cardiovascular-, and strength training sessions per week, two supervised, one unsupervised session at home.



The patient receives guides on Active Cycle of Breathing Exercise (ACBEx).