Research Article|Articles in Press

Implementing a Virtual Mind-Body Prehabilitation Program for Patients Undergoing Thoracic Surgery – A Quality Improvement Project

Open AccessPublished:March 17, 2023DOI:
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      Prehabilitation (prehab) before thoracic surgery has been found to improve outcomes in patients with cancer, however COVID-19 presented challenges to access on-site programs. We describe the development, implementation, and evaluation of a synchronous, virtual mind-body prehab program developed in response to COVID-19.


      Eligible participants were patients seen at a thoracic oncology surgical department of an academic cancer center, >= 18 years of age with a diagnosis of thoracic cancer and referred at least one week before surgery. The program offered two 45-minute pre-operative mind-body fitness classes each week delivered via Zoom. We collected data for referrals, enrollment, participation, and evaluated patient reported satisfaction and experience. We conducted brief semi-structured interviews about participants’ experience.


      Among 278 patients referred, 260 were approached, and of those 197 (76%) patients agreed to participate. Among participants, 140 (71%) attended at least one class, with an average of 11 attendees per class. Majority of participants reported being extremely satisfied (97.8%), extremely likely to recommend the classes to others (91.2%), and indicated that classes were very much helpful in preparing for surgery (90.8%). Patients also reported that the classes helped reduce anxiety/stress (94.2%), fatigue (88.5%), pain (80.7%), and shortness of breath (86.5%). Qualitative data further suggest that the program made participants feel stronger, more connected to their peers, and better prepared for surgery.


      This virtual mind-body prehab program was well-received with high satisfaction and benefits and is highly feasible to implement. This approach may help overcome some of the challenges to in-person participation.

      Graphical abstract



      Prehab, Prehabilitation (The process of enhancing physical fitness before surgery to enable the patient to withstand the stress of surgery has been termed prehabilitation. Exercise is an important component of prehabilitation), IMS (Integrative Medicine Service), ASCO (American Society of Clinical Oncology), MSK (Memorial Sloan Kettering Cancer Center), Q&A (Questions and Answers)