Abdominal Aortic Aneurysm
Conditions
Keywords
aaa, prehabilitation, quality of life, physical therapy, open surgery
Brief summary
This is a pilot, prospective, randomized control trial that aim to provide a first estimation of the 3-month post-operative variation in the functional recovery of patients who benefited from an outpatient pre-habilitation program and patients who did not benefit from it.
Detailed description
Open surgery of abdominal aortic aneurysms (AAA) is the reference treatment in a large number of cases. This is a heavy procedure performed in patients around 70 years of age. In post-operative open aortic surgery, a stay in aftercare and rehabilitation is often necessary, especially in fragile patients. The goal is to increase the patient's overall functional status to allow him to move away from the threshold below which he loses his independence for activities of daily living. The pre-habilitation protocol includes 3 parts : 1. Oral nutrition ensures adequate caloric and protein intake to support muscle anabolism 2. Muscle building over a few sessions with a liberal physiotherapist to learn exercises and then independently 3. Cardio-respiratory endurance. For the experimental group: Initial visit with adaptive rehabilitation physician, 6-8 weeks prior to surgery: * Clinical examination with Wood classification - limits and restrictions. * Assessment of environmental resources * Definition pre-habilitation protocol and post-operative rehabilitation pathway * application of the ambulatory pre-approval protocol defined with the adaptive rehabilitation physician. For the control group: Support without pre-approval with application of other common practices of the service. Follow up of both groups: Post-operative follow-up visits with the surgeon (gathering the necessary information for comparative follow-up). Mail-out of World Health Organisation Disability Assessment Schedule (WHODAS) 2.0, Euro Qol (EQ)-5D-5L and DIJON questionnaires at 3 and 6 months post-operative.
Interventions
OTHERPREHABILITATION
Customized program made by the physical therapist based on the first visit. It includes 3 parts : 1. Nutrition advices that ensures adequate caloric and protein intake to support muscle anabolism 2. Muscle building over a few sessions with a physiotherapist to learn exercises and then independently redo them 3. Cardio-respiratory endurance exercises.
Sponsors
University Hospital, Toulouse
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
Monocentric, interventional, randomized, controlled, open study.
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Patient with an abdominal aortic aneurysm (Thoraco-abdominal aneurysm type 4/Supra renal/Juxta-renal/Sub renal) treated with conventional surgery. * Surgical indication of aneurysm by size (50-55mm)
Exclusion criteria
\- Patient requiring urgent management that does not allow for a pre-authorisation protocol of at least 6 weeks.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| functional WHODAS 2.0 score | T0 : Right after the open surgery for AAA | the WHODAS 2.0 score ranges from 12 to 60 : 12 representing no difficulty at all, 60 representing worst difficulty to engage in usual activities |
Countries
France
Contacts
Primary ContactAurélien Hostalrich, MD
Backup ContactVirgile Pinelli, MD
Outcome results
None listed