Sample descriptive characteristics at baseline.

BackgroundDespite the high frequency of inguinal hernia repair (IHR) surgery, there is little research investigating pre- or post-operative exercise and education in this population. Recommendations regarding perioperative physical activity are inconsistent and largely based on clinical opinion. We conducted a pilot randomized controlled trial to examine the feasibility of perioperative rehabilitation for inguinal hernia repair surgery in terms of recruitment rate, assessment, and protocol implementation.MethodsParticipants were randomized into an intervention group and control group. Descriptive and patient-reported data were collected through online surveys at baseline, post-prehabilitation (prehab), 1-week post-operative (post-op), and 12-week post-op. Eligible participants completed a performance-based modified Short Form Functional Capacity Evaluation conducted by a masked observer at baseline, after 6 weeks of exercise and/or education, and at 12-week post-op. Participants in the intervention group received 6 weeks of exercise and education prior to and then after surgery. The control group received care as usual.ResultsThirty-one participants awaiting IHR with a mean age of 49 years were recruited (recruitment rate of 51.7%). Thirty participants were randomized into control (n = 16) and intervention groups (n = 14), while 1 dropped out prior to beginning the study due to being unable to take time off work for assessment. Twenty-four participants completed the final 12-week post-op follow-ups. Twenty-one participants returned to work by the 12-week post-op follow-up. Sixty-seven percent of participants in the intervention group exercised at least 3 times per week post-operatively. One participant in each group experienced exacerbations of hernia symptoms that were unrelated to study activities. Functional testing resulted in minimal symptom exacerbation in either group, but the intervention group reported less pain at 12-week post-op than controls.ConclusionA randomized trial of perioperative rehabilitation for patients undergoing inguinal hernia repair appears feasible, but protocol adjustments are needed to improve recruitment rate, assessment, and participant retention.Trial Registration: This trial is registered with ClinicalTrials.gov Identifier: NCT05069142

背景：尽管腹股沟疝修补术（inguinal hernia repair, IHR）的手术开展频次极高，但针对该人群的术前或术后运动与教育相关研究却极为匮乏。当前关于围手术期身体活动的临床推荐意见并不统一，且大多基于临床主观判断。本研究开展了一项先导性随机对照试验，旨在从招募率、评估方案及流程执行情况三个维度，探讨腹股沟疝修补术围手术期康复方案的可行性。

方法：研究对象被随机分配至干预组与对照组。研究人员分别于基线期、术前康复（prehabilitation, prehab）阶段结束时、术后1周及术后12周，通过在线调查收集描述性数据与患者报告结局数据。符合入组标准的受试者需在基线期、6周运动与/或教育干预结束后，以及术后12周，接受由设盲观察者实施的基于表现的改良版简明功能能力评估。干预组受试者在术前及术后均接受为期6周的运动与教育干预，对照组则接受常规诊疗护理。

结果：本研究共招募31名等待接受腹股沟疝修补术的受试者，平均年龄为49岁，整体招募率达51.7%。其中30名受试者被随机分配至对照组（n=16）与干预组（n=14），另有1名受试者因无法抽出时间参与评估而在研究启动前退出。最终共有24名受试者完成了术后12周的随访。截至术后12周随访时点，已有21名受试者恢复工作。干预组中有67%的受试者术后每周至少完成3次运动。两组各有1名受试者出现疝症状加重情况，且该症状加重与研究活动无关。功能测试结果显示，两组受试者的症状均未出现明显加重，但干预组在术后12周时的疼痛评分显著低于对照组。

结论：针对接受腹股沟疝修补术患者的围手术期康复随机试验具备临床可行性，但仍需对试验方案进行优化调整，以提升招募效率、完善评估流程并提高受试者留存率。

试验注册：本试验已在ClinicalTrials.gov平台注册，注册号为NCT05069142。