Researchers tested a new way to help older adults who are weak or frail prepare for hip, knee, or other bone surgery. The program included phone coaching, nutrition advice, exercise plans, and a review of their medicines before and after surgery. Most patients who were asked to join said yes, they stuck with the exercise and eating advice, and both patients and doctors thought the program was helpful and doable. The study shows this preparation approach is ready to be tested more thoroughly to see if it helps people recover better and costs less.

The Quick Take

  • What they studied: Can older adults with frailty successfully prepare for bone surgery using a program that includes coaching calls, nutrition help, exercise, and medicine reviews?
  • Who participated: Older adults scheduled for elective orthopedic surgery (like hip or knee replacement) who were identified as frail or weak. About 78% of eligible people agreed to participate in the study.
  • Key finding: The program worked well—patients completed most of their coaching calls, followed nutrition and exercise advice at high rates, and half of participants had at least one medicine changed after review. Both patients and healthcare workers said the program was acceptable and practical.
  • What it means for you: If you’re an older adult facing joint surgery, a structured preparation program combining exercise, nutrition, and medicine review appears to be feasible and well-received. However, this was a small test study, so larger research is needed to confirm it actually improves recovery and reduces costs.

The Research Details

This was a feasibility study, which is like a test run before doing a bigger experiment. Researchers weren’t trying to prove the program works yet—they were checking if it’s practical and if people will actually do it. They collected information in three ways: patients filled out health surveys, doctors reviewed medical records, and researchers interviewed both patients and healthcare workers about their experiences.

The study looked at several important things: How many people could they recruit? Did patients actually show up and participate? Did they follow the advice? Did they think it was helpful? What problems came up? By asking these questions, the researchers could figure out what needed to be fixed before testing the program on a larger scale.

The program itself had multiple parts working together: patients got phone calls from coaches, received personalized nutrition advice, did exercises designed for their situation, and had all their medicines reviewed by a pharmacist or doctor to make sure they weren’t taking anything unnecessary or harmful.

Before spending money and time on a large study, researchers need to know if their idea actually works in the real world. This feasibility study answered important questions: Can we find and recruit enough patients? Will they actually participate? Will they follow the plan? Do doctors and patients think it’s a good idea? These answers help researchers design better, more successful large studies that can truly show whether the program helps people recover faster and spend less time in the hospital.

This study was well-designed for its purpose as a feasibility test. It used multiple ways to collect information (surveys, medical records, and interviews), which gives a fuller picture than just one method. The researchers talked to both patients and healthcare workers, which helps identify real-world challenges. However, this was a small test study without a comparison group, so we can’t say for certain that the program actually improves health outcomes—that’s what the larger study will test. The study was honest about what worked and what needed improvement, which is exactly what a good feasibility study should do.

What the Results Show

The program successfully reached older adults needing surgery. About 30% of people referred for surgery were screened for frailty, and among those who qualified, 78% agreed to participate—a very high acceptance rate. Patients were supposed to receive eight coaching phone calls, and they actually completed six of them on average, showing good participation.

Patients did a great job following the advice they received. Both the nutrition recommendations and exercise plans had high adherence rates, meaning people actually did what they were asked to do. When doctors reviewed patients’ medications, they found that half of the participants were taking medicines they didn’t need or that could cause problems, and these were changed or stopped.

Both patients and healthcare workers had positive things to say about the program. Interviews showed that people appreciated having their care tailored to their individual needs, valued the support from doctors and family members, and thought it was helpful that different types of healthcare providers worked together as a team.

The research team discovered several important details about what made the program work well. Patients especially valued when their care was personalized rather than one-size-fits-all. The support from family members and healthcare professionals was crucial—people felt more motivated when they had this backing. When different healthcare providers (doctors, nurses, physical therapists, pharmacists) communicated well with each other, the program ran more smoothly. The study also identified some practical challenges, like the difficulty of coordinating care with local rehabilitation services and general practitioners, which the team plans to improve.

This study builds on growing evidence that preparing patients before surgery (called prehabilitation) can help them recover better. The multicomponent approach—combining exercise, nutrition, medicine review, and coaching—is more comprehensive than many previous programs. The focus on older adults with frailty is important because this group often has more complications after surgery and needs extra support. The high acceptance rate and adherence suggest this approach may work better than simpler programs that only focus on one area like exercise alone.

This was a small test study without a comparison group, so we can’t say for certain that the program actually improves recovery or reduces hospital costs—that’s what the larger study will test. The study didn’t measure whether patients actually recovered better or had fewer complications after surgery. We don’t know if the results would be the same in different hospitals or with different types of patients. The study was done in one location, so the findings might not apply everywhere. Some patients may have been more motivated than others, which could affect how well the program worked.

The Bottom Line

If you’re an older adult facing elective orthopedic surgery and your doctor offers a prehabilitation program with coaching, nutrition support, exercise, and medicine review, it appears to be safe and practical to try. The evidence suggests high confidence that the program is feasible and acceptable. However, we have moderate confidence in recommending it specifically for improving recovery outcomes, since larger studies are still needed to prove those benefits. Talk with your healthcare team about whether this type of program is available and right for your situation.

This research is most relevant for older adults (typically 65+) who are scheduled for elective orthopedic surgery like hip or knee replacement and who may be frail or have multiple health conditions. Healthcare providers, hospital administrators, and insurance companies should care about this because it shows a practical way to prepare high-risk patients for surgery. Family members of older adults facing surgery should also pay attention, as they can play an important support role. People with other types of surgery might benefit from similar approaches, but this study specifically tested it for bone surgery.

The preparation program in this study lasted from before surgery through the immediate recovery period. Patients would need to commit to about 6-8 weeks of coaching calls, exercise, and nutrition changes before surgery. Benefits like better recovery, fewer complications, and shorter hospital stays would likely appear in the weeks and months after surgery, not immediately. Long-term benefits might take several months to fully appear as patients regain strength and function.

Want to Apply This Research?

  • Track daily exercise completion (yes/no) and weekly adherence to nutrition recommendations. Also log any medication changes made by your doctor and note how you’re feeling before surgery (energy level, strength, mood on a 1-10 scale).
  • Use the app to set reminders for your coaching calls and exercise sessions. Create a simple meal plan tracker to monitor whether you’re eating the recommended foods. Set a goal to complete at least 5 of your 6-8 coaching calls and to do your prescribed exercises at least 4 days per week.
  • Weekly check-ins on exercise completion and nutrition adherence. Monthly reviews of your progress with your healthcare team. Track any changes to your medications and note how you’re feeling. After surgery, continue tracking your recovery progress, pain levels, and return to normal activities to see if the preparation helped.

This study tested whether a preparation program for surgery is practical and acceptable, but it did not prove that it improves actual health outcomes or recovery. Larger research studies are still needed to confirm whether this program reduces complications, shortens hospital stays, or improves long-term recovery. Always consult with your surgeon and healthcare team before starting any new exercise program or making changes to your diet or medications, especially if you have existing health conditions. This information is educational and should not replace personalized medical advice from your healthcare providers.