The STRONG-Hernia trial was terminated early after randomizing only 43 of a planned 398 patients, so it was not powered to assess postoperative complications; the STRONG program 'seems promising for optimizing risky lifestyles', though these results are preliminary.
The trial recruited far fewer patients than planned and was terminated early because of slow recruitment.
Most participants had one risky lifestyle factor, and obesity was the most common.
Prehabilitation led to a much higher proportion of participants with all risky lifestyles optimized at end of intervention.
Postoperative complications at 30 days did not differ significantly between groups, but the trial was underpowered.
EQ-5D VAS stayed unchanged with prehabilitation but decreased in controls, while EQ-5D-5L index changes were similar between groups.
Recruitment challenges included patient outsourcing, an insufficient recruitment strategy, and a low inclusion rate.
The study was a multicenter, parallel-group, centrally randomized trial with blinded final outcome assessment and analyses.
This study tested whether a six-week program of weekly hospital sessions could help people with unhealthy lifestyle habits (smoking, poor nutrition including obesity, risky alcohol use, or physical inactivity) get healthier before planned hernia surgery, and whether this would reduce complications afterward. Patients were randomly assigned to the program or to usual care. The trial planned to enroll nearly 400 patients but managed only 43 before being stopped early, mainly because of recruitment problems such as patients being sent elsewhere for surgery and a recruitment approach that was not effective enough. Among those who completed the program, most (13 of 19) had improved all of their risky habits, compared with none of 22 in the usual-care group. Complication rates after surgery were similar (3 of 16 versus 4 of 19), but with so few patients this trial could not determine whether the program affects complications. Self-rated health stayed stable in the program group but fell in the usual-care group. This research suggests that the program may help people change risky lifestyle habits before surgery, but these findings are preliminary. The main contribution is a clearer picture of recruitment pitfalls, which could help researchers design a larger trial that can properly test whether such programs reduce surgical complications.
Upload your bloodwork. We'll cross-reference your results against this study and 4,700 others.
Upload Your LabsJensen S, Lauridsen S, Fonnes S, Rosenberg J, Brandstrup B, Helgstrand F, et al.. (2026). STRONG prehabilitation before elective ventral hernia repair: Learnings from recruitment challenges in a randomized controlled trial.. PloS one. https://doi.org/10.1371/journal.pone.0360482