Preoperative rehabilitation and education program for surgery (PREPS): A pilot randomized control trial protocol

Background: We designed a program for prehabilitation and education before a shoulder replacement (PREPS) that is based on reviews of relevant literature, and is co-designed with preferences of patients recruited from the wait list for a shoulder replacement, and a transdisciplinary healthcare sample. The content and format was integrated in a comprehensive, patient-centered program combining exercise, preparedness for surgery, motivational interviewing, and pain management principles. This patient-centered program has the potential to improve postoperative pain, function, and patient-oriented outcomes, decrease postoperative opioid use and short- and long-term healthcare costs. This pilot randomized controlled trial will evaluate feasibility and satisfaction with our program for individuals undergoing a shoulder replacement. Methods: Participants (n = 90) undergoing a shoulder replacement will be randomized into (1) a 6-week self-directed online pre-rehab and education program, (2) a 6-week online pre-rehab and education program with a therapist to monitor progression of PREPS or (3) a standard of care group. The PREPS program intervention groups will be delivered virtually with an online program of modules and a written handbook. Feasibility outcomes include recruitment rate, adherence, content acceptability, study acceptability, outcome measure completion rates and treatment fidelity. Outcomes will be assessed at baseline and 1 day before surgery, then post-operatively at 6 weeks and 3,6 and 12 months. Discussion: The proposed project will include the feasibility testing of a prehabilitation and education program with potential to improve surgical outcomes for shoulder replacement patients. Results of this study will provide the foundation for a future fully powered multicenter trial. Trial Registration: NCT05965986.