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Introduction <p>Prehabilitation is an increasingly recognised strategy designed to optimise patients’ physical, nutritional, and psychological status before major surgery. While the benefits of trimodal prehabilitation have been documented, we developed and implemented a quadrimodal model that incorporates occupational therapy as a fourth component. This comprehensive intervention targets frail patients with advanced oncogynecologic disease, a population at high risk for postoperative complications.</p> Material and methods <p>The study recruited 40 patients, 32 of whom successfully completed an intensive 3-week prehabilitation programme. The programme comprised four modules: physiotherapy, nutritional support, psychological support, and occupational therapy. Patients completed 4&#xa0;days of inpatient care and 3&#xa0;days of home care per week. The effectiveness of the programme was assessed using a range of methods, including physical tests (6-min walk test, 5 × sit-to-stand test), psychological status questionnaires (perceived stress scale) and nutritional assessment using established questionnaires (MUST and PONS).</p> Results <p>The results demonstrated statistically significant enhancements in physical fitness assessments, a decline in the frailty index, and an augmentation in psychological well-being. Notably, three patients no longer fulfilled the frailty criteria at the conclusion of the programme. Spirometric parameters, including FVC, FEV1, and PEF, exhibited substantial improvement. The nutritional intervention resulted in a reduction in the number of patients at high risk of malnutrition. Additionally, there was a notable improvement in the nutritional parameters.</p> Conclusion <p>This quadrimodal prehabilitation model, integrating occupational therapy, demonstrated effectiveness in preparing frail oncologic patients for radical surgery. The approach not only improved physical and psychological readiness but also allowed for patient stratification into responders and non-responders. Its implementation in clinical practice could enhance patient outcomes and reduce the burden of postoperative recovery.</p>

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Prehabilitation beyond the trimodal standard: occupational therapy in a quadrimodal cancer care model

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月26日

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  • Tomáš Brtnický,
  • Markéta Polková,
  • Marie Tichá,
  • Peter Koliba,
  • Oľga Dubová,
  • Michal Zikán,
  • Alena Jarolímková,
  • Petr Hubka,
  • Pavel Kabele,
  • Jana Matějíčková,
  • Petra Ovesná,
  • Petra Sládková

摘要

Introduction

Prehabilitation is an increasingly recognised strategy designed to optimise patients’ physical, nutritional, and psychological status before major surgery. While the benefits of trimodal prehabilitation have been documented, we developed and implemented a quadrimodal model that incorporates occupational therapy as a fourth component. This comprehensive intervention targets frail patients with advanced oncogynecologic disease, a population at high risk for postoperative complications.

Material and methods

The study recruited 40 patients, 32 of whom successfully completed an intensive 3-week prehabilitation programme. The programme comprised four modules: physiotherapy, nutritional support, psychological support, and occupational therapy. Patients completed 4 days of inpatient care and 3 days of home care per week. The effectiveness of the programme was assessed using a range of methods, including physical tests (6-min walk test, 5 × sit-to-stand test), psychological status questionnaires (perceived stress scale) and nutritional assessment using established questionnaires (MUST and PONS).

Results

The results demonstrated statistically significant enhancements in physical fitness assessments, a decline in the frailty index, and an augmentation in psychological well-being. Notably, three patients no longer fulfilled the frailty criteria at the conclusion of the programme. Spirometric parameters, including FVC, FEV1, and PEF, exhibited substantial improvement. The nutritional intervention resulted in a reduction in the number of patients at high risk of malnutrition. Additionally, there was a notable improvement in the nutritional parameters.

Conclusion

This quadrimodal prehabilitation model, integrating occupational therapy, demonstrated effectiveness in preparing frail oncologic patients for radical surgery. The approach not only improved physical and psychological readiness but also allowed for patient stratification into responders and non-responders. Its implementation in clinical practice could enhance patient outcomes and reduce the burden of postoperative recovery.