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Prehabilitation Network

The topic of our international network is “Prehabilitation prior to cardiac procedures” and focuses on individuals who are about to undergo an elective cardiac intervention or surgery. The network consists of experts in the field of (cardiac) prehabilitation and/or rehabilitation, geriatrics, cardiology, cardiac surgery, anaesthesiology, neurology, psychocardiology, psychology, sports science, nutrition, and physiotherapy. The great advantage of the interdisciplinary and multi-professional network lies in the diverse experience its members have gained in past and ongoing prehabilitation studies. The participants of the network will meet three times each year to achieve the predefined milestones. Every year, a full-day symposium is held at the Heart and Brain Center of the University Medical Center in Göttingen, Germany. The network is being funded by the German Research Foundation for three years.

Network participants

Responsible         

Steinmetz, Carolin; PhD
Postdoctoral Researcher, Project Coordinator, Department of Geriatrics, University Medical Center Göttingen, Germany, https://orcid.org/0000-0002-5190-9551

Co-responsible

Sadlonova, Monika; M.D.
Attending Physician for Consultation-Liaison Psychosomatic Medicine and Psychotherapy, Department of Cardiovascular and Thoracic Surgery, University Medical Center Göttingen (UMG), Göttingen, Germany, Clinician Scientist, Department of Psychosomatic Medicine and Psychotherapy, Department of Geriatrics, UMG, Göttingen, Germany, Research Consultant, Massachusetts General Hospital, Harvard Medical School, Boston, USA, University Medical Center Göttingen, Germany, https://orcid.org/0000-0003-3629-252X

The active network members

  • von Arnim, Christine; M.D., Director of the Department of Geriatrics, University Medical Center Göttingen, Germany, https://orcid.org/0000-0002-8614-2223
  • Müller-Werdan, Ursula; M.D., Director of the Department of Geriatrics and Medical Gerontology , Charité, University Medical Center Berlin, Germany, https://orcid.org/0000-0003-4440-8991
  • Kutschka, Ingo; M.D., Director of the Department of Cardiothoracic- and VascularSurgery, University Medical Center Göttingen, Germany, https://orcid.org/0000-0002-7358-3513
  • Akowuah, Enoch; M.D., Consultant Cardiac Surgeon and Chair of Cardiac Surgery, South Tees NHS Foundation Trust and Translational and Clinical Research Institute University of Newcastle, Great Britain, https://orcid.org/0000-0002-2429-3579
  • Reiss, Nils; M.D., Head of Department of Cardiac Rehabilitation and Professor at Hannover Medical School, Schüchtermann-Klinik Bad Rothenfelde, Bad Rothenfelde, Germany
  • Puls, Miriam; M.D., Apl. Professor and Senior Attending Physician, Clinic for Cardiology and Pneumology, University Medical Center Göttingen, Germany, https://orcid.org/0000-0001-5540-1264
  • Walther, Claudia; M.D., Interventional Cardiologist, MVZ CCB am Agaplesion Bethanien Krankenhaus Frankfurt am Main, Germany
  • Scheenstra, Bart; M.D., Cardiologist, Basalt, Leiden/The Hague, The Netherlands, https://orcid.org/0000-0001-5778-2574
  • Johnson Akeju, Seun; M.D., Anesthetist-in-Chief, Massachusetts General Hospital, Head of the Department of Anaesthesia at Massachusetts General Hospital, Harvard Medical School, https://orcid.org/0000-0002-0237-0756
  • Lee, Anna; PhD, Professor, Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong (CUHK), Hong Kong, China, https://orcid.org/0000-0003-2864-0045
  • Celano, Christopher; M.D., Associate Director, Cardiac Psychiatry Research Program, Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA, https://orcid.org/0000-0003-0547-2851
  • Rief, Winfried; M.D., W3-Professor, Faculty of Psychology, Philipps-University Marburg, Germany, https://orcid.org/0000-0002-7019-2250
  • Salzmann, Stefan; M.D., a. Professor, Medical Psychology, b. Post-Doctoral Researcher, Clinical Psychology and Psychotherapy/ a. Health and Medical University, Erfurt, Germany, b. Philipps University of Marburg, Germany, https://orcid.org/0000-0002-9597-0303
  • Silver, Julie; M.D., Senior Associate Dean , Wake Forest University School of Medicine, Winston Salem, NC, USA, https://orcid.org/0000-0001-9711-0713
  • Kiselev, Jörn; PhD, Professor for Physiotherapy, University for Applied Sciences, Fulda, Germany, https://orcid.org/0000-0002-8657-1669
  • Kehler, Scott; PhD, Assistant Professor, School of Physiotherapy, Faculty of Health, Dalhousie University, Canada, https://orcid.org/0000-0002-2154-2306
  • Hartog, Johanneke; PhD, Postdoctoral Researcher, University Medical Center Groningen, Groningen, The Netherlands, https://orcid.org/0000-0002-2434-4997
  • Gillis, Chelsia; PhD,  a. Assistant Professor, b. Associate Member, c. Nutrition Consultant/ a. School of Human Nutrition, McGill University, Montreal, Canada, b. Surgery and Anesthesia Department, McGill University, Montreal, Canada, c. PeriOperative Program, Montreal General Hospital, Montreal, Canada, https://orcid.org/0000-0002-0615-5922

Milestones

Over the next three years, our interdisciplinary network aims to achieve the following milestones (details see figure below):

  • 1a: Systematic review and meta-analysis of prehabilitation interventions
  • 1b: Review and summary of current guidelines, consensus statements about prehabilitation prior to a cardiac procedure
  • 2: Consensus of cardiac prehabilitation program prior to cardiac procedures
  • 3: Prepare consensus article of prehabilitation recommendations in cardiac patients
  • 4: National and international dissemination of network outcomes
Download Dokument "Milestones.jpg"(JPG - 231.6 KB)

Overview of the meetings

The network will meet three times each year. During the funding period of three years, each year one meeting will be a full day symposium, which all members will attend in person. The symposium will include expert presentations on selected research topics and will give space to support the network itself. The other two yearly meetings will be virtual and will last approximately 120 minutes (30 minutes guest speaker, 30 minutes discussion, 60 minutes for an update of the working groups and coordination of the next steps).  

  • 27.09.2024, 2:30pm to 4:30pm CET, Dr. Monika Sadlonova; Dr. Carolin Steinmetz and Prof. Ingo Kutschka, Prof. Christine von Arnim, Zoom – Kick-off Meeting
  • 22.11.2024, 2:30pm to 4:30pm CET, Prof. Dr. Michael Denkinger, Zoom
  • 28.03.2025, 9:00am to 5:00pm CET, Prof. Dr. Francesco Carli (Zoom), Prof. Dr. Birna Bjarnason-Wehrens, Prof. Dr. Martin Halle, Symposium (1 day): Heart & Brain Center at the University Medical Center, Goettingen, Germany
  • 26.09.2025, 2:30pm to 4:30pm CET, Prof. Anna Lee, Zoom
  • 28.11.2025, 2:30pm to 4:30pm CET, Prof. Dr. Christoph Herrmann-Lingen, Zoom
  • 27.02.2026, 9:00am to 5:00pm CET, Prof. Dr. Arora Rakesh, Dr. Katrin Schmidt, Guido Perrot, Symposium (1 day):  Heart & Brain Center at the University Medical Center, Goettingen, Germany
  • 25.09.2026, 2:30pm to 4:30pm CET, Prof. Dr. Massimo Mariani, Zoom
  • 20.11.2026, 2:30pm to 4:30pm CET, Prof. Dr. Christine von Arnim, Zoom
  • 26.02.2027, 9:00am to 5:00pm CET, Chosen Experts from different Network working groups, Symposium: Heart & Brain Center at the University Medical Center, Goettingen, Germany

News

First Network Symposium

The first network symposium took place on March 28, 2025, at the Heart & Brain Center, University Medical Göttingen, Germany. We were honored to welcome three distinguished guest speakers: Prof. Francesco Carli (Montreal, Canada), Prof. Birna Bjarnason-Wehrens (Cologne, Germany), and Prof. Martin Halle (Munich, Germany). More than 20 participants from eight countries attended in person, with additional attendees joining online.The program featured expert insights on preoperative testing for elective procedures, prehabilitation exercise training for patients with various cardiac conditions, and safety considerations in submaximal exercise testing. Interactive discussions - both in plenary and smaller working groups - focused on defining cardiac prehabilitation and shaping the content of the core prehab modules: Exercise, Preoperative Optimization, and Psychological Intervention.

Network members Johanneke Hartog (Groningen, Netherlands) and Bart Scheenstra (Leiden, Netherlands) shared their experiences from the Heart-ROCQ study and the Digital Cardiac Counseling Trial. The day concluded with a group discussion on different prehabilitation settings (inpatient, outpatient, digital), exploring which settings best suit specific patient groups. A key focus was defining inclusion and exclusion criteria for these different approaches.

We sincerely thank our national and international guests for their valuable contributions and engaging discussions!

Turning plans into progress

Our network’s efforts progressed with the second international meeting, held on November 22, 2024.

First, Prof. Dr. Anna Lee gave insights into her newly conducted study “Effect of exercise prehabilitation on quality of recovery after cardiac surgery” which was published in the British Journal of Anasthesia in November 2024. Similarly, Dr. Bart Scheenstra reported about his study “The Effect of Teleprehabilitation on Adverse Events After Elective Cardiac Surgery”, which was published in the Journal of the American College of Cardiology in October 2024. 

The meeting continued with the lecture “The cardiac geriatric patient – how and when to make a difference?” by Prof. Dr. Michael Denkinger. Prof. Denkinger identified critical areas of geriatric care which require improvement and shared his insights on how to achieve better outcomes for geriatric cardiac patients.

The final segment of the meeting was dedicated to defining prehabilitation and its modules. 

The first in-person symposium will be held at the Heart & Brain Center at the University Medical Center in Göttingen, Germany, on March 28, 2025. 

Information on currently published prehab articles by two active network members

The Effect of Teleprehabilitation on Adverse Events After Elective Cardiac Surgery: A Randomized Controlled Trial                     

Journal of the American College of Cardiology 

https://doi.org/10.1016/j.jacc.2024.10.064

This study, conducted by our network-member Dr. Bart Scheenstra and colleagues, explored the effectiveness of teleprehabilitation, a remote-based exercise and prehabilitation program, on reducing adverse events following elective cardiac surgery. Patients were assigned to either a teleprehabilitation group, which received virtual exercise guidance and support before surgery, or a control group which received the usual care. 

Findings indicated that teleprehabilitation significantly reduced the incidence of postoperative complications, including infections, cardiovascular events, and respiratory issues, compared to the usual care group. Additionally, patients in the teleprehabilitation group had improved functional capacity and faster recovery. The results suggest that teleprehabilitation may be a promising and accessible intervention to enhance recovery and minimize adverse events after cardiac surgery.

                        

Effect of Exercise Prehabilitation on Quality of Recovery After Cardiac Surgery: 
A Single-centre Randomised Controlled Trial                     

British Journal of Anaesthesia

https://doi.org/10.1016/j.bja.2024.08.039

Prof. Anna Lee, who is also an active member of the prehabilitation-network, and her colleagues investigated the impact of exercise prehabilitation on recovery outcomes for 164 prefrail to frail patients undergoing cardiac surgery. Patients were randomly assigned to either a prehabilitation group, which received a structured exercise program (twice a week) prior to surgery, or a control group that did not participate in preoperative exercise.

The results showed that, although the physical prehabilitation program did not improve early quality of recovery scores post-surgery, it successfully lowered disability levels, meaning less impairment in performing daily activities at 90 days after surgery, compared to control patients. The evidence highlighted that that exercise-based prehabilitation was safe and could be a valuable intervention for a faster recovery and an improved overall quality of life in cardiac surgery patients.

Kick-off meeting

We are thrilled to announce that the kick-off meeting of the international “Prehabilitation Network”, which is funded by the German Research Foundation, took place on September 27, 2024.

The network consists of prehab experts from seven countries (Germany, Switzerland, the Netherlands, the United Kingdom, China, Canada, and the USA). In all these countries, prehabilitation is at different stages of implementation in the healthcare systems. The exchange of ideas and experiences will be very valuable in bringing prehabilitation to a higher level worldwide.

Twenty-seven participants including interested listeners took part in our virtual meeting. After a round of introductions to get to know each other, we gave an overview about our milestones, Prof. Dr. med. Christine von Arnim introduced the PRECOVERY trial, and Prof. Dr. med. Ingo Kutschka, MBA gave a lecture on Enhanced Recovery After Surgery (ERAS) and prehabilitation.

We would like to thank everyone for the participation and look forward to our next meeting on November 22, 2024

The active network members:

Prof. Dr. Christine von Arnim, Prof. Dr. Ursula Müller-Werdan, Prof. Dr. med. Ingo Kutschka, MBA, Prof. Dr. Enoch Akowuah, Prof. Dr. Nils Reiss, Prof. Dr. Miriam Puls, PD Dr. Claudia Walther, Prof. Dr. Oluwaseun Johnson-Akeju, Prof. Dr. Anna Lee, Prof Dr. Christopher Celano, Prof. Dr. Winfried Rief, Prof. Dr. Stefan Salzmann, Prof. Dr. Julie Silver, MD, Prof. Dr. Jörn Kiselev, Assist. Prof. Scott Kehler, Dr. Johanneke Hartog, Dr. Bart Scheenstra, Assist. Prof. Chelsia Gillis, Dr. Monika Sadlonova, M.D. and Dr. Carolin Steinmetz

Projektkoordinatorin | Wissenschaftliche Mitarbeiterin

Dr. Carolin Steinmetz

Dr. Carolin Steinmetz

Kontaktinformationen

  • Publikationen

    Wissenschaftliche Mitarbeiterin, Sportwissenschaftlerin, Projektkoordinatorin von PRECOVERY und Lehrbeauftragte am Gesundheitscampus Göttingen (HAWK)

    Frau Dr. Carolin Steinmetz ist seit Oktober 2022 als wissenschaftliche Mitarbeiterin in der Klinik für Geriatrie der UMG tätig. Ihr Arbeitsschwerpunkt liegt in der Projektkoordination von PRECOVERY.                                     

    Nach dem Studium der Sportwissenschaften mit dem Schwerpunkt „Rehabilitation und Prävention“ an der Deutschen Sporthochschule (DSHS) Köln (Abschluss „Diplom Sportwissenschaftlerin“) arbeitete sie für zwei Jahre im betrieblichen Gesundheitsmanagement der DekaBank bei Medical Park City Med Frankfurt GmbH in Frankfurt am Main. Im Anschluss sammelte sie Erfahrungen im rehabilitativen Setting (Schwerpunkte: Kardiologie, Pneumologie und Angiologie) in ihrer achtjährigen Tätigkeit als Sporttherapeutin und Leitung der Sport- und Bewegungstherapie im stationären Rehabilitationszentrum der Kerckhoff-Klinik in Bad Nauheim. Frau Steinmetz promovierte an der DSHS Köln zu dem Thema „Prärehabilitation vor aortokoronarer Bypass-Operation“ (Betreuerin: Frau Prof´in Birna Bjarnason-Wehrens, Institut für Kreislaufforschung und Sportmedizin). Nach der Dissertation entschied sich Frau Steinmetz für eine universitäre Laufbahn und sammelte zwei Jahre Erfahrung in ihrer Tätigkeit als Lehrkraft für besondere Aufgaben am Institut für Sportwissenschaften, Arbeitsbereich „Trainings- und Bewegungswissenschaft“ der Georg-August-Universität Göttingen als auch eineinhalb Jahre als Wissenschaftliche Mitarbeiterin/Post-Doktorandin am Institut für Sportwissenschaften, Professur für „Trainingswissenschaft“ an der Universität der Bunderwehr in München.

    Forschungsschwerpunkte:

    • Trainingswissenschaftliche Interventionsforschung in der Sekundärprävention von Patientinnen und Patienten mit kardiovaskulären, onkologischen und viralen Erkrankungen
    • Prehabilitation in der Kardiochirurgie/Kardiologie
    • Sarkopenie und Sturzprävention bei v.a. geriatrischen Patientinnen und Patienten
    • Entwicklung von Assessmentverfahren für App-unterstützende Lösungen in der Trainingssteuerung u.a. für die Patientennachsorge
Oberärztin, Schwerpunkt klinische Studien (Heart and Brain)

PD Dr. med. Monika Sadlonova

PD Dr. med. Monika Sadlonova

Kontaktinformationen

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