Researchers tested whether personalized coaching before major surgery helps patients recover better than standard written programs. Fifty-eight patients either received weekly one-on-one remote coaching tailored to their needs or followed a paper-based program. The personalized group showed better physical fitness, fewer serious complications after surgery, and their immune system responded differently to the training. These immune changes suggest the body was better prepared for surgery. This study shows that customized pre-surgery preparation may help patients heal faster and experience fewer problems after their operation.

The Quick Take

  • What they studied: Whether getting personalized coaching before surgery helps patients prepare better than following a standard written program
  • Who participated: 54 patients (average age 57, mostly women) scheduled for major surgery at one hospital. They were randomly assigned to either personalized coaching or standard program groups
  • Key finding: Patients who received personalized coaching walked farther in a 6-minute test, had fewer serious complications after surgery, and showed specific immune system changes that suggest better surgical readiness
  • What it means for you: If you’re having major surgery, personalized pre-surgery training with a coach may help you recover better and experience fewer problems. However, this is one study at one hospital, so talk to your doctor about what’s available to you

The Research Details

This was a randomized controlled trial, which is considered one of the strongest types of research. Researchers randomly assigned 58 patients to two groups: one received personalized prehabilitation (pre-surgery training) with weekly one-on-one remote coaching sessions, while the other group followed a standard paper-based program. Both programs covered the same four areas: physical activity, nutrition, brain training, and mindfulness. The study ran from June 2020 to September 2022 at a single academic medical center.

The personalized group had a coach who adjusted their program based on how they were progressing each week. The standard group received written instructions but no personalized feedback or adjustments. Researchers measured physical fitness (how far patients could walk, how quickly they could stand up and sit down), thinking ability, and immune system function before and after the training program.

Understanding how pre-surgery training affects the immune system is important because a stronger, better-prepared immune system may help prevent infections and other complications after surgery. This study looked at specific immune cells and how they respond, which helps explain why personalized training might work better than generic programs. By measuring immune changes, researchers could see the biological reasons why some patients recovered better

This study has several strengths: it was randomized (reducing bias), had a control group for comparison, measured specific immune markers using advanced technology, and tracked real surgical outcomes. However, it was conducted at only one hospital with a relatively small number of patients (54 completed the study), so results may not apply to all hospitals or all types of surgery. The study was also single-blinded, meaning patients knew which group they were in, which could influence their effort and results

What the Results Show

Patients in the personalized coaching group showed meaningful improvements in physical fitness. In the 6-minute walk test (where patients walk as far as they can in 6 minutes), the personalized group improved from an average of 496 meters to 546 meters. The standard group also improved, but the personalized group’s improvement was statistically significant.

Most importantly, the personalized group had fewer serious complications after surgery. Only 4 patients in the personalized group experienced moderate-to-severe complications compared to 11 in the standard group. This is a meaningful difference that suggests personalized training genuinely helped patients recover better.

The immune system changes were striking. The personalized group showed specific changes in immune cells that suggest their bodies were better prepared for the stress of surgery. These changes involved reducing inflammatory signals that are known to cause problems like infections and thinking difficulties after surgery. The standard group did not show these immune changes, even though they improved slightly in physical fitness.

Beyond the main findings, patients in the personalized group also showed improvements in cognitive (thinking) tests and other physical measures like the timed-up-and-go test (how quickly someone can stand, walk, and sit back down). The personalized group’s immune system showed dampened inflammatory responses in specific types of immune cells, particularly monocytes and T-cells, which are key players in fighting infection and managing inflammation

Previous research has suggested that pre-surgery training helps, but results have been mixed because programs weren’t tailored to individual patients. This study adds important evidence that personalization matters. The finding that immune system changes accompany better outcomes supports the theory that pre-surgery training works by preparing the body’s defense system. This aligns with growing research showing that inflammation is a major cause of post-surgery complications

This study was conducted at only one hospital, so results may not apply everywhere. The sample size was relatively small (54 patients completed it), which limits how confident we can be about the results. Patients knew which group they were in, which might have motivated the personalized group to try harder. The study didn’t include very sick patients (those with high anesthesia risk scores) or patients having emergency surgery, so results may not apply to them. Finally, the study only measured outcomes for a limited time after surgery, so we don’t know about long-term effects

The Bottom Line

If you’re scheduled for major elective surgery and your doctor approves, consider asking about personalized pre-surgery training programs that include physical activity, nutrition guidance, cognitive training, and stress management. The evidence suggests this approach may reduce your risk of complications. However, this is based on one study, so discuss options with your surgical team. Standard pre-surgery programs are still beneficial, but personalized coaching appears to offer additional benefits (moderate confidence level)

This research is most relevant for people scheduled for major elective surgery who are healthy enough to exercise. It may be especially important for older adults or those with health conditions that increase surgical risk. People having emergency surgery or those too sick to exercise were not included in this study, so results may not apply to them. Talk to your surgical team about whether pre-surgery training is appropriate for your situation

The training program in this study lasted several weeks before surgery. Patients showed measurable improvements in physical fitness and immune function within this timeframe. Benefits in terms of fewer complications appeared immediately after surgery. However, this study didn’t track long-term recovery, so we don’t know how long benefits last

Want to Apply This Research?

  • Track weekly physical activity minutes, nutrition quality (servings of fruits/vegetables), cognitive training sessions completed, and mindfulness/stress management practice. Set a goal of 150 minutes of moderate activity per week, 5+ servings of produce daily, 3+ cognitive sessions weekly, and 10+ minutes of mindfulness daily
  • Use the app to schedule and complete weekly coaching check-ins (or self-guided sessions if coaching unavailable), log daily physical activity with specific exercises, track meals and nutrition goals, complete brain training games, and practice guided mindfulness or meditation. Set reminders for each domain and track consistency rather than perfection
  • Create a pre-surgery readiness dashboard showing progress in all four domains (physical, nutrition, cognitive, mindfulness). Track baseline measurements (like a timed walk test) and repeat them weekly to show improvement. Monitor consistency of program adherence as the strongest predictor of success. After surgery, track recovery milestones and any complications to correlate with pre-surgery preparation level

This research describes findings from a single clinical trial and should not replace medical advice from your healthcare provider. Before starting any pre-surgery training program, consult with your surgeon and medical team to ensure it’s appropriate for your specific condition and health status. Results from this study may not apply to all patients, hospitals, or types of surgery. Individual outcomes vary based on many factors including age, overall health, type of surgery, and adherence to the program. This information is educational and not a substitute for professional medical guidance.