There is no universally accepted definition for surgical prehabilitation. The objectives of this scoping review were to (1) identify how surgical prehabilitation is defined across randomised controlled trials and (2) propose a common definition. The final search was conducted in February 2023 using MEDLINE, Embase, PsycINFO, Web of Science, CINAHL, and Cochrane. We included randomised controlled trials (RCTs) of unimodal or multimodal prehabilitation interventions (nutrition, exercise, and psychological support) lasting at least 7 days in adults undergoing elective surgery. Qualitative data were analysed using summative content analysis. We identified 76 prehabilitation trials of patients undergoing abdominal (n=26, 34%), orthopaedic (n=20, 26%), thoracic (n=14, 18%), cardiac (n=7, 9%), spinal (n=4, 5%), and other (n=5, 7%) surgeries. Surgical prehabilitation was explicitly defined in more than half of these RCTs (n=42, 55%). Our findings consolidated the following definition: ‘Prehabilitation is a process from diagnosis to surgery, consisting of one or more preoperative interventions of exercise, nutrition, psychological strategies and respiratory training, that aims to enhance functional capacity and physiological reserve to allow patients to withstand surgical stressors, improve postoperative outcomes, and facilitate recovery.’ A common definition is the first step towards standardisation, which is needed to guide future high-quality research and advance the field of prehabilitation. The proposed definition should be further evaluated by international stakeholders to ensure that it is comprehensive and globally accepted.

中文翻译：

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走向手术预康复的共同定义：随机试验的范围审查


手术预康复没有普遍接受的定义。本次范围审查的目的是（1）确定如何在随机对照试验中定义手术预康复，以及（2）提出一个通用定义。最终检索于 2023 年 2 月使用 MEDLINE、Embase、PsycINFO、Web of Science、CINAHL 和 Cochrane 进行。我们纳入了对接受择期手术的成人进行持续至少 7 天的单模式或多模式预康复干预（营养、运动和心理支持）的随机对照试验 (RCT)。使用总结性内容分析来分析定性数据。我们确定了 76 项康复前试验，患者接受腹部手术 (n=26, 34%)、骨科手术 (n=20, 26%)、胸部手术 (n=14, 18%)、心脏手术 (n=7, 9%)、脊柱手术 (n=7, 9%) n=4, 5%) 和其他 (n=5, 7%) 手术。超过一半的随机对照试验明确定义了手术预康复（n=42，55%）。我们的研究结果巩固了以下定义：“术前康复是从诊断到手术的过程，由运动、营养、心理策略和呼吸训练等一项或多项术前干预组成，旨在增强功能能力和生理储备，使患者能够承受手术压力源，改善术后结果并促进康复。通用定义是迈向标准化的第一步，这是指导未来高质量研究和推进康复领域发展所必需的。拟议的定义应由国际利益攸关方进一步评估，以确保其全面并得到全球接受。