Prehabilitation

Preoperative rehabilitation, or prehab, is a form of multidisciplinary healthcare interventions which aim to dampen side effects of medical or surgical intervention. Multidisciplinary team involvement can range from physiotherapists, occupational therapists, respiratory therapists, doctors, pharmacologists, psychologists, psychiatrists and sports physiologists.[1]

Prehab can be applied to surgical populations in oncology, cardiorespiratory, cardiovascular and orthopaedic settings. The intention is that increasing baseline fitness prior to surgery will allow for relatively higher fitness post-operatively. Prehabilitation interventions are tailored to the patient so that even those with high amounts of comorbidities can receive a positive outcome. Research evidence is mixed, but suggests that prehabilitation reduces hospital stays and therefore risk of hospital acquired infections such as pneumonia.[1]

In 2013, a pilot study of prehabilitation in colorectal surgery found that it improved postoperative functional recovery, measured in terms of the walking capacity at 4 weeks and 8 weeks (although the time in hospital and post-operative complications were similar),[2] is also being considered for use in some cardiovascular interventions,[3] and may also be of some benefit for preventing lung complications, such as pulmonary atelactasis, in general surgery.[4]

References
  1. "Principles and guidance for prehabilitation within the management and support of people with cancer" (PDF). 2019.
  2. Li C, Carli F, Lee L, et al. (April 2013). "Impact of a trimodal prehabilitation program on functional recovery after colorectal cancer surgery: a pilot study". Surgical Endoscopy. 27 (4): 1072–82. doi:10.1007/s00464-012-2560-5. PMID 23052535.
  3. Alkarmi A, Thijssen DH, Albouaini K, et al. (June 2010). "Arterial prehabilitation: can exercise induce changes in artery size and function that decrease complications of catheterization?". Sports Medicine. 40 (6): 481–92. doi:10.2165/11531950-000000000-00000. PMID 20524713.
  4. Jack S, West M, Grocott MP (September 2011). "Perioperative exercise training in elderly subjects". Best Practice & Research. Clinical Anaesthesiology. 25 (3): 461–72. doi:10.1016/j.bpa.2011.07.003. PMID 21925410.


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