Abstract: Objective: To develop and evaluate a perioperative multimodal exercise intervention program based on The Transtheoretical Model for pancreatic cancer patients with sarcopenia, providing scientific evidence for optimizing rehabilitation nursing strategies in the perioperative period. Methods: A total of 117 surgical patients with pancreatic cancer and sarcopenia from a tertiary grade A hospital in Xuzhou, admitted between January 2023 and December 2024, were selected by convenience sampling and randomly assigned to either an intervention group (n=58) or a control group (n=59). The intervention program was developed through literature review, patient interviews, expert consultation, and a pilot survey. The intervention group received this program in addition to routine care, while the control group received routine care only. Grip strength, Appendicular Skeletal Muscle Mass Index (ASMI), physical function (Short Physical Performance Battery, SPPB), self-efficacy (Exercise Self-Efficacy Scale, ESES), and quality of life (Sarcopenia and Quality of Life Questionnaire-Chinese Version, SarQoL?-CN) were compared between the two groups. Results: At four weeks post-surgery, the intervention group showed significantly higher grip strength [(19.98±4.07) kg], SPPB scores (4.62±1.69), and ESES scores (13.51±2.42) compared to the control group [(17.40±3.83) kg, 3.98±1.56, 12.53±2.73, respectively; all P<0.05]. At 12 weeks post-surgery, the intervention group demonstrated significantly better outcomes in grip strength, ASMI, SPPB, ESES, and SarQoL?-CN compared to the control group (all P<0.05). Conclusion: The perioperative multimodal exercise intervention program effectively improved muscle strength, physical function, exercise self-efficacy, and quality of life in pancreatic cancer patients with sarcopenia.

Key words: multimodal exercise; The Transtheoretical Model; pancreatic cancer; sarcopenia; perioperative period