Aging Innovation in Perioperative Medicine and Surgery (AIMS)
Our research
AIMS leads and collaborates on research that improves surgical care, recovery, and long-term outcomes for older adults and other patients recovering from surgery. Our work spans prehabilitation, frailty, recovery at home, patient-centered outcomes, virtual care, and health system innovation.
On this page:
Research areas
Our work is built on four key research pillars that span the perioperative journey, from preparing for surgery to recovering at home. Through these interconnected areas, we work to improve patient experiences, outcomes, and the delivery of care across health systems.
Perioperative frailty
Our team studies how living with frailty influences surgical outcomes. We develop tools and interventions to help health care providers assess risk and support patient-centered decision-making.
Prehabilitation and recovery
We develop and evaluate programs that help patients improve their physical and cognitive health before surgery and support recovery afterward.
Surgical outcomes and patient-centred care
We investigate outcomes that matter most to patients, including disability, functional recovery, quality of life, and remaining at home after surgery.
Virtual care and health system innovation
We study new models of care designed to improve access, support recovery at home, and make perioperative care more effective, accessible, and sustainable.
Current and completed trials
AIMS research spans the surgical journey, from preparing for surgery to recovery and longer-term outcomes. The examples below highlight selected programs and studies that reflect the breadth and evolution of our work and are not a comprehensive list of all current or past projects.
STRIVE
The STRIVE (Structured TRaining to Improve fitness in a Virtual Environment) Before Surgery Trial is a multicentre study that delivers home-based exercise, nutrition support, and breathing exercises through a virtual platform for patients preparing for major surgery.
The goal is to determine whether a virtually supported prehabilitation program can improve fitness, reduce disability, and support recovery after surgery.
Co-Principal Investigators
Dr. Chelsia Gillis, Dr. Julie Hallet, Gurlie Kidd, Dr. Monica Taljaard, Dr. Puneeta Tandon, Dr. Duminda Wijeysundera, Dr. Susan Lee
ALOFT
The ALOFT Pilot Trial (Anesthesia for Lower limb revascularization to Optimize Functional ouTcomes) is a multi-centre pilot randomized control trial comparing two standard of care approaches to anesthesia (neuraxial versus general anesthesia) for patients having lower limb revascularization surgery.
The goal is to evaluate three pragmatic elements (recruitment, adherence, and follow-up) in a pilot trial, necessary to support a successful, large-scale evaluation. We will concurrently use implementation science methodology to further refine processes for the larger trial. The future full ALOFT trial will be designed to evaluate the comparative effectiveness of two different anesthesia types for improving outcomes.
Co-Principal Investigators
Dr. Derek Roberts, Dr. Angela Jerath, Gurlie Kidd, Dr. Monica Taljaard, Dr. Tarit Saha, Dr. Duminda Wijeysundera
ACCELERATE
The ACCLERATE Study (Advancing Cognition and Cognitive reserve before ELective surgery to Enhance cognitive Recovery And TrajEctories) explores whether cognitive training before surgery can help support brain health and cognitive recovery in older surgical patients. Participants complete brain-training activities before surgery designed to build cognitive reserve, with the potential to support brain health and reduce complications such as delirium after surgery.
The goal is to evaluate whether a home-based, coach-supported cognitive prehabilitation program is feasible for older adults preparing for major surgery. helping our team understand whether this type of intervention can be successfully delivered and inform a future larger trial.
Co-Principal Investigators
Dr. Leandra Amado, Dr. Shirley Huang, Dr. Peter Greenstreet, Dr. Monica Taljaard
PROAKTIVE
The PROAKTIVE (PRO-Active Rehabilitation Prior to Kidney Transplantation to ImproVe Patient-centered Recovery Evaluation) supports people awaiting kidney transplantation through home-based exercise, nutrition guidance, and emotional support before and after surgery.
The goal is to evaluate the feasibility (recruitment, adherence, retention) before embarking on a full-scale trial to evaluate the effectiveness on patient-centered recovery.
Co-Principal Investigators
Dr. Ryan McGinn, Dr. Stephanie Hoar
RESPONSE
The RESPONSE Study (RESpiratory Prehabilitation to enhance Outcomes after plaNned thoracic Surgery Evaluation) is a quality improvement project helping patients prepare for thoracic surgery through breathing exercises, respiratory muscle training, and coaching from respiratory health experts.
The goal is to support recovery and reduce postoperative pulmonary complications by improving respiratory health before surgery.
Co-Principal Investigators
Dr. Andrew Seely, Dr. Puneeta Tandon, Dr. Monica Taljaard
VICTORY
The VICTORY Trial (Virtual, Innovative, postsurgical Care To Optimize Return home for older people with frailtY) is a multicentre randomized controlled trial comparing virtual postoperative care using CloudDX technology with standard postoperative care.
The goal is to determine whether virtual care can increase the number of days older adults living with frailty are alive and at home during the first 30 days following planned surgery.
Co-Principal Investigators
Dr. Sylvie Aucoin, Dr. Manoj Lalu, Gurlie Kidd, Dr. Michael Jacka, Dr. Derek Dillane, Dr. Jordan Leitch, Mike McGillion
PREPARE
The PREPARE Trial (PReoperative Exercise to decrease PostoperAtive complication Rates and disability scorEs) was a large Canadian trial that studied whether home-based exercise and nutrition before surgery could improve recovery for older adults living with frailty. More than 800 patients across 13 hospitals participated. Overall, prehabilitation did not reduce disability or complications after surgery, but patients who completed most of the program had better recovery from disability. These findings are helping shape the next generation of more accessible and effective prehabilitation programs.
Co-Principal Investigators
Dr. Susan Lee, Dr. Dean Fergusson, Dr. Chelsia Gillis, Dr. Rachel G. Khadaroo, Amanda Meliambro, Dr. John Muscedere, Dr. Antoine Eskander, Dr. Husein Moloo, Dr. Gregg Nelson, Dr. Tarit Saha, Dr. Rosaleen Chun, Dr. Pablo E. Serrano, Dr. Duminda N. Wijeysundera, Dr. Monica Taljaard, PREPARE Trial Investigator Group
TRACTION
The TRACTION Trial (Tranexamic Acid to Reduce Transfusion in Major Non-Cardiac Surgery) was a large Canadian trial involving more than 8,000 patients undergoing major non-cardiac surgery. It tested whether routinely giving tranexamic acid, a medication that reduces bleeding, could reduce the need for blood transfusions. Patients receiving tranexamic acid were less likely to need a transfusion, without an increase in blood clots. These findings support a simple, widely available approach to improving surgical care.
Co-Principal Investigators
Dr. Brett Houston, Dr. Rodney Breau, Peter Greenstreet, Dr. Meghan Andrews, Dr. Sinzianna Avramescu, Dr. Hema Bagry, Dr. Robert Balshaw, Dr. Jayesh Daya, Dr. Kaitlin Duncan, Dr. Christopher Harle, Dr. Eric Jacobsohn, Dr. Tina Kerelska, Dr. Marshall Pitz, Dr. Paul Komenda, Dr. Sarah McIsaac, Dr. Tim Ramsay, Dr. Tarit Saha, Dr. Alan Tinmouth, Angela Recio, Dayna Solvason, Dr. Daniel Szoke, Dr. Marshall Tenenbein, Dr. Robert Talarico, Dr. Dean Fergusson, Dr. Ryan Zarychanski
UNDERSTANDING WHAT WORKS IN PREHABILITATION: A SYSMETATIC REVIEW
AIMS researchers brought together evidence from 186 randomized trials involving more than 15,000 surgical patients to understand which types of prehabilitation are most promising. The review found that exercise and nutrition, alone or as part of combined programs, may help reduce complications, shorten hospital stays, and improve recovery. Exercise showed the most consistent benefits across outcomes. The findings are helping guide the design and delivery of future prehabilitation programs.
Co-Principal Investigators
Dr. Gregory L. Bryson, Dr. Alan J. Forster, Dr. Sylvain Gagne, Dr. Allen Huang, Dr. Manoj Lalu, Dr. Luke T. Lavallée, Dr. Husein Moloo, Dr. Julie Nantel, Dr. Barbara Power, Dr. Celena Scheede-Bergdahl, Dr. Carl van Walraven, Dr. Colin J.L. McCartney, Dr. Monica Taljaard
THE PREHABILITATION STUDY
The Prehabilitation Study: Exercise Before Surgery to Improve Patient Function in People with Cancer was a study of older adults living with frailty who were preparing for cancer surgery. The study compared a home-based exercise program before surgery with usual care. Overall, the program did not improve recovery after surgery. However, people who completed more of the recommended exercise tended to have better recovery, suggesting that finding ways to help patients stay engaged with prehabilitation may be important.
Co-Principal Investigators
Dr. Laura Boland, Dr. Brian Hutton, Dr. Chelsia Gillis, Dr. Areti Angeliki Veroniki, Dr. Guillaume Martel, Gurlie Kidd
Frequently Asked Questions
Collaborators
AIMS works closely with clinicians, researchers, educators, patients and health care organizations across Canada to advance perioperative research.
