In recent years, the concept of prehabilitation has emerged as a promising strategy to help patients prepare for major surgery. A comprehensive 2023 scientific review examined 48 trials focusing on prehabilitation before orthopedic procedures and found a notable reduction in severe complications. Prehabilitation, typically lasting four to five weeks, involves tailored routines of diet, exercise, and social support, which have been shown to significantly improve surgical outcomes. However, a 2024 study raises questions about its effectiveness for older adults, highlighting the need for further research.
The term "prehabilitation" refers to the process of preparing patients physically and mentally before surgery to enhance recovery outcomes. A systematic review and meta-analysis in 2023 found that prehabilitation significantly improved function, quality of life, muscle strength, and reduced back pain in patients, compared to those who did not engage in pre-operative preparation. The study evaluated over 3,500 patients, emphasizing the potential benefits of prehabilitation.
“The idea that exercise, nutrition, and psychosocial support would lead to better outcomes after surgery is, on one hand, common sense,” – McIsaac
A randomized clinical trial in 2023 further supports these findings. Researchers analyzed 251 adults with colorectal cancer undergoing surgery and discovered that those who exercised regularly before their procedure faced a 50% lower risk of complications. The combination of exercise and social support also resulted in patients spending two fewer days in the hospital. Additionally, individuals who adhered to a healthy diet experienced a 38% lower risk of complications compared to those who did not.
Despite these promising results, there are limitations to consider. Many studies within the 2023 review focused on a single hospital, which could affect the generalizability of the findings. Moreover, a 2024 study specifically examining older adults suggests that prehabilitation may not be as effective for this demographic. These findings underscore the importance of tailoring prehabilitation programs to individual needs and circumstances.
“Our review found that prehabilitation based on exercise, nutrition, and especially exercise combined with other approaches were the most promising types of prehabilitation,” – McIsaac
A typical prehabilitation program may involve adjustments to diet, focusing on specific foods or macronutrients as recommended by healthcare professionals. Dr. Tracey Childs emphasizes the importance of consulting with surgeons and medical specialists to receive personalized advice on preparing for surgery.
“Patients should check with their surgeon as well as their medical specialists and request advice for preparing for surgery,” – Tracey Childs, MD
The timing of prehabilitation is crucial. The sooner patients begin preparing for surgery, the more effective the process is likely to be. Dr. Childs underscores this point by noting that even small changes in routine can make a significant difference.
“The sooner one starts getting ready for surgery, the more effective the prehabilitation will be,” – Tracey Childs, MD
Prehabilitation does not necessarily mean engaging in an intense new training regimen. As Sutherland explains, it can involve simple activities such as aerobic exercises, regular walks in the week leading up to the procedure, strength training, and resistance work.
“This doesn’t mean starting an intense new training regimen; It simply can involve aerobic activity, going on regular walks the week before the procedure, strength training, and some resistance work,” – Sutherland
The emphasis on beginning recovery before surgery is gaining traction in medical circles. Dr. Chelsia Gillis highlights the shift in perspective towards recovery starting even before the surgical incision.
“We have adopted a view that recovery begins before the surgical incision,” – Chelsia Gillis, PhD
The effectiveness of prehabilitation varies depending on individual circumstances and needs. Patients who focus on a combination of diet, exercise, and social support experience a 36% lower risk of complications. This highlights the importance of a personalized approach to prehabilitation.
Daniel McIsaac underscores the potential of these findings for both patients and researchers.
“With this information, we can now move forward in helping patients to know what strategies may be best for them to prepare for surgery, and for researchers what key areas need to be the focus of new studies,” – Daniel McIsaac, MD
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