Multimodal Prehabilitation Program Versus Usual Care for Older Adults Undergoing Lumbar Fusion Surgery to Improve Recovery and Reduce Complications

What this Trial Is About

This research aims to evaluate a tailored multimodal prehabilitation program called PHYSIO-Prehab for adults aged 75 years and older with degenerative lumbar spinal diseases who are scheduled for elective lumbar fusion surgery. The study addresses the increased risk of postoperative complications and delayed recovery faced by older adults due to age-related decline and comorbidities. It is a multicenter, randomized controlled trial designed to provide high-quality evidence for improving patient-centered perioperative care in this population. Participants will be randomly assigned to either the intervention group or the usual care group. The intervention group will undergo a 6-week PHYSIO-Prehab program, including three biweekly supervised group sessions covering lectures and discussions, along with home-based multicomponent exercise such as resistance, balance, aerobic, and stretching training. Additional components include nutritional optimization, management of comorbidities like anemia, hypertension, and diabetes, and cognitive prehabilitation with brain protection strategies. The control group will receive standard health education via a manual. Both groups will receive consistent perioperative Enhanced Recovery After Surgery care as implemented by the participating hospitals. Throughout the study, participants will be assessed for changes in independence in daily activities using the Barthel Index from baseline to 30 days after surgery. Secondary outcomes include pain levels, disability, patient satisfaction, complications within 30 days after surgery, hospital stay length, discharge status, and readmissions. The trial will recruit from April 2026 to December 2027 and use statistical analysis to evaluate the feasibility and efficacy of the PHYSIO-Prehab program in improving recovery and reducing complications for elderly spinal surgery patients.

Pre-operative Risk Assessment Combined With Targeted Intervention in the Chinese Elderly With Spine Surgery II