Nurse-coordinated multidisciplinary prehabilitation for older adults with frailty undergoing elective transcatheter aortic valve replacement: protocol for a randomised controlled trial

Introduction Frailty assessment can identify older adults undergoing transcatheter aortic valve replacement (TAVR) who are at increased risk of disability and poor functional recovery despite procedural success. A nurse-coordinated, multidisciplinary prehabilitation model may integrate the physical, nutritional, educational and psychological components needed to address these vulnerabilities, but randomised evidence in this population remains limited. Methods and analysis This investigator-initiated, single-centre, assessor-blinded, parallel-group randomised controlled trial will enrol 96 adults aged 65–90 years with an Essential Frailty Toolset score of 3 or greater who are scheduled for elective TAVR. Participants will be randomised 1:1 to usual perioperative care alone or usual care plus a nurse-coordinated prehabilitation programme. The intervention combines supervised aerobic and functional exercise, respiratory training, individualised nutritional optimisation, structured education and psychological support from the day after admission until the day before TAVR. The primary outcomes are 6-minute walk distance within 48 hours before hospital discharge and health-related quality of life assessed using the EuroQol 5-Dimension 5-Level at 1 and 3 months after discharge. Secondary outcomes are hospital-associated disability and post-TAVR complications. Additional exploratory and process outcomes include anxiety and depressive symptoms, functional capacity at other time points, hospital costs, feasibility, adherence, acceptability and safety. The primary analysis will follow the intention-to-treat principle. Ethics and dissemination The Biomedical Ethics Review Committee of West China Hospital, Sichuan University, approved the protocol (approval no. 2025 Review (2324)). The trial was prospectively registered in the Chinese Clinical Trial Registry on 22 May 2026 (ChiCTR2600125252). Results will be submitted to a peer-reviewed journal and presented at scientific conferences. Trial registration number ChiCTR2600125252.