{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T03:10:56Z","timestamp":1789614656996,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Major abdominal surgery is associated with a high rate of post\u2010operative complications with increased risk of adverse surgical outcomes due to the presence of frailty. This study aims to evaluate the effectiveness of the multimodal Recovery of Surgery in the Elderly (ROSE) prehabilitation program with supervised exercise in mitigating postoperative functional decline when compared to standard care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The ROSE program enrolled ambulant patients who were 65\u00a0years and above, had a Clinical Frailty Scale score of 4 or more and were planned for major abdominal surgery. Participation in supervised exercise sessions before surgery were compared with standard physiotherapy advice. The primary outcome was 6\u2010min walk test (6MWT) distance assessed at baseline, after prehabilitation and 30\u00a0days follow\u2010up after surgery. Secondary outcomes included physical performance, length of hospital stay and postoperative morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data from 74 eligible patients, 37 in each group, were included. Median age was 78\u00a0years old. Forty\u2010two patients (22 in Prehab group and 20 in control group) with complete 6MWT follow\u2010up data at 30\u00a0days follow\u2010up were analysed for outcomes. Most patients underwent laparoscopic surgery (63.5%) and almost all of the surgeries were for abdominal malignancies (97.3%). The Prehab group had an increase in 6MWT distance at the 30\u2010day follow up, from a baseline mean (SD) of 277.4 (125) m to 287.6 (143.5) m (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.415). The 6MWT distance in the control group decreased from a baseline mean (SD) of 281.7 (100.5) m to 260.1 (78.6) m at the 30\u2010day follow up (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.086). After adjusting for baseline 6MWT\u00a0distance and frailty score, the Prehab group had significantly higher 6MWT distance at 30\u2010day follow\u2010up than control (difference in adjusted means 41.7\u00a0m, 95% confidence interval 8.7\u201374.8\u00a0m, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.015). There were no significant between\u2010group differences in the secondary outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A multimodal prehabilitation program with supervised exercise within a short time frame can improve preoperative functional capacity and maintain baseline functional capacity in frail older adults undergoing major abdominal surgery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjs.12016","type":"journal-article","created":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T15:15:11Z","timestamp":1703085311000},"page":"48-58","source":"Crossref","is-referenced-by-count":9,"title":["Recovery of surgery in the elderly (ROSE)\u00a0program: The efficacy of a multi\u2010modal prehabilitation program implemented in frail and pre\u2010frail elderly undergoing major abdominal surgery"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2063-2286","authenticated-orcid":false,"given":"Jaclyn Jie Ling","family":"Chow","sequence":"first","affiliation":[{"name":"Tan Tock Seng Hospital Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe Hao Timothy","family":"Teo","sequence":"additional","affiliation":[{"name":"Tan Tock Seng Hospital Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanchalika","family":"Acharyya","sequence":"additional","affiliation":[{"name":"Tan Tock Seng Hospital Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selvaganapathi","family":"Natesan","sequence":"additional","affiliation":[{"name":"Tan Tock Seng Hospital Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seng Kwing","family":"Cheong","sequence":"additional","affiliation":[{"name":"Tan Tock Seng Hospital Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swapna","family":"Tony","sequence":"additional","affiliation":[{"name":"Tan Tock Seng Hospital Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya Wei","family":"Ong","sequence":"additional","affiliation":[{"name":"Tan Tock Seng Hospital Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan Jennifer","family":"Li","sequence":"additional","affiliation":[{"name":"Tan Tock Seng Hospital Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bei","family":"Wang","sequence":"additional","affiliation":[{"name":"Tan Tock Seng Hospital Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jye Yi","family":"Chai","sequence":"additional","affiliation":[{"name":"Tan Tock Seng Hospital Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui Zhen","family":"Tam","sequence":"additional","affiliation":[{"name":"Tan Tock Seng Hospital Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jee Keem","family":"Low","sequence":"additional","affiliation":[{"name":"Tan Tock Seng Hospital Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"issue":"2","key":"e_1_2_10_2_1","first-page":"e10","article-title":"Tailoring Surgery to Elderly Patients with Cancer","volume":"103","author":"Audisio R. A.","year":"2016","journal-title":"Special Issue: Surgery in the Elderly"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.17674"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afx157"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871\u2010018\u20100516\u20106"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16\u20100652"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2004.05.280"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9394"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdu540"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010018\u20104801\u20109"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010019\u20101069\u20103"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.5435\/00124635\u2010200607000\u201000002"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.629207"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.050051"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010020\u201001801\u20107"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021\u20109681(87)90171\u20108"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl\u20102013\u2010304588"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq433"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/014860718701100108"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010015\u20104478\u20101"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.166.1.at1102"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2014.03.005"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1179\/jmt.2008.16.4.82E"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.4103\/ija.IJA_533_1"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895\u20104356(89)90065\u20106"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010020\u201005658\u20100"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.13239"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2021.628848"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31828dbac2"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.8773"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hkpj.2014.04.001"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.3389\/fresc.2021.650835"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2019.5474"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.05.014"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010015\u20102961\u20104"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15215"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010016\u20103379\u20108"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010012\u20102560\u20105"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2016.1268268"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013259.pub2"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.11622\/smedj.2016158"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1017\/S002966511500419X"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14507"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.12016","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T07:08:44Z","timestamp":1718176124000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjs.12016"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,15]]},"references-count":43,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1002\/wjs.12016"],"URL":"https:\/\/doi.org\/10.1002\/wjs.12016","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,15]]}}}