Physical and Psychological Effects of Home-Based vs Face-to-Face Prehabilitation in Individuals With Severe Obesity Awaiting Bariatric and Metabolic Surgery: Protocol for a Randomized Controlled Trial.
Matte D, Nascimento A, Andrade A, Vilarino G • JMIR research protocols • 2026
This protocol describes a randomized controlled trial designed to compare the effectiveness of home-based versus face-to-face prehabilitation programs on physical and psychological outcomes in individuals with severe obesity awaiting bariatric and metabolic surgery.
Key Findings
Methods
The trial will use a three-arm parallel-group randomized controlled design to compare home-based prehabilitation, face-to-face prehabilitation, and a control group in individuals with grade III obesity awaiting bariatric and metabolic surgery.
Participants will be allocated via block randomization in a 1:1:1 ratio across the three groups
Eligible participants must have grade III obesity and an indication for bariatric and metabolic surgery (BMS)
The study is described as a protocol paper, meaning no outcome data have yet been collected or analyzed
Recruitment is scheduled to begin in April 2026, with the intervention phase expected to be completed in September 2026
Methods
The intervention protocol consists of 7 weeks of prehabilitation including 12 combined aerobic and resistance exercise sessions and 3 health education sessions.
The 7-week program includes 1 week of familiarization followed by 6 weeks of training
Sessions combine aerobic and resistance exercise modalities
Health education sessions are included as a component of both intervention arms
Both the face-to-face and home-based groups receive the same structure of sessions
Methods
The primary outcome measure is the total score of the Hospital Anxiety and Depression Scale (HADS), reflecting a focus on psychological status as a key target of prehabilitation.
HADS subscales (HADS-A for anxiety and HADS-D for depression) are designated as secondary outcomes
Secondary outcomes also include sleep quality, mood states, self-efficacy, and quality of life
Functional performance secondary outcomes include the 6-minute walk test, handgrip strength, and 5-repetition sit-to-stand test
The choice of psychological primary outcome reflects the protocol's aim to optimize both physical and psychological status before surgery
Methods
Recruitment will be stratified to ensure ecological validity by targeting 50% low-income and 20% rural participants.
The stratified recruitment strategy is described as designed 'to ensure ecological validity'
Inclusion of low-income and rural participants is intended to address accessibility barriers associated with face-to-face delivery
The authors note that 'face-to-face delivery can limit accessibility' for individuals with severe obesity
This design element reflects an equity focus in the trial's implementation
Background
The study was funded in August 2025 by the Research Support Program of the Santa Catarina State University, with results expected to be published in mid-2027.
The intervention phase is expected to be completed in September 2026
Data analysis is planned between October and November 2026
The trial aims to provide evidence to 'support the implementation of feasible, accessible, equitable, and cost-effective preoperative care models'
The authors note that 'evidence on home-based approaches remains scarce,' indicating a gap this trial seeks to address
Background
The authors identify obesity as a growing public health issue associated with comorbidities and substantial medical costs, for which bariatric and metabolic surgery is often recommended but may benefit from preoperative optimization.
Prehabilitation is described as potentially able to 'optimize physical and psychological status' before bariatric and metabolic surgery
The protocol frames BMS as 'often recommended for individuals with severe obesity'
The rationale for home-based prehabilitation is grounded in accessibility limitations of face-to-face programs
The trial is designed to generate comparative effectiveness evidence between delivery modalities
What This Means
This paper describes the design of a clinical trial (not yet completed) that will test whether exercise and education programs done at home can be just as effective as in-person programs for people with severe obesity who are waiting to have weight-loss surgery. The program lasts 7 weeks and combines aerobic exercise, strength training, and health education sessions. The main question the researchers want to answer is whether these programs reduce anxiety and depression — which are common in people awaiting major surgery — and whether the home-based version works as well as the face-to-face version.
The trial is designed with equity in mind, specifically aiming to enroll people from low-income backgrounds (50% of participants) and rural areas (20% of participants). This is important because people in these groups often have trouble attending in-person medical programs due to transportation, cost, or distance. By including these populations deliberately, the researchers hope to find out whether home-based prehabilitation can reach people who would otherwise not have access to preoperative care.
This research suggests that if home-based prehabilitation proves effective, it could offer a more accessible and cost-effective way to prepare patients for bariatric surgery, potentially improving surgical outcomes and patient wellbeing for a broader range of people. The study has not yet collected data — results are expected to be published in mid-2027 — so this paper outlines the plan rather than reporting conclusions.
Check Your Own Numbers
Upload your bloodwork. We'll cross-reference your results against this study and 4,700 others.
Matte D, Nascimento A, Andrade A, Vilarino G. (2026). Physical and Psychological Effects of Home-Based vs Face-to-Face Prehabilitation in Individuals With Severe Obesity Awaiting Bariatric and Metabolic Surgery: Protocol for a Randomized Controlled Trial.. JMIR research protocols. https://doi.org/10.2196/87053