Having Surgery? Get Prehabilitation!

May 2018

Fit U Today Monthly Newsletter

Surgery is often needed to address physical conditions, however, it also brings much stress to the individual, with both physiological and psychological impact. Research studies have found that preoperative physical fitness, nutrition status, and psychological well-being can be strong predictors for surgical recovery. Conversely, individuals with lower fitness levels, nutrition status and mental health may have more surgical complications and slower recovery rates. Prehabilitation as a preoperative process has been recommended to enhance functional and mental capacity prior to the stressful incidence of a surgery. Specifically, in a surgical setting, preoperative physical conditioning includes exercise and nutrition while psychological conditioning includes stress management and education, all aimed at strengthening the body and mind in advance of surgery and to limit the declines post- surgery. For example, in one study, 42 patients undergoing colorectal cancer surgery participated in a one month trimodal prehabilitation program. The program consisted of aerobic exercise (3 times/week), nutrition counselling to reduce body fat and optimize protein intake, and 90 minutes of anxiety-reduction and stress management sessions with a clinical psychologist. These patients were compared with 45 controls who did not participate in a prehabilitation program. The comparisons showed that the prehabilitation patients were able to able to walk greater distances than the controls during a 6-minute walk test at 1 month and 2 months post-surgery. The prehabilitation group also showed greater levels of physical activity post-surgery compared to the controls. At the 2 month follow-up, a marked difference showed that 81% of the prehabilitation patients recovered to their baseline walking capacity compared to 40% of the control group.1 Research studies have shown that prehabilitation patients have reduced pain and hospitalization, and an accelerated return to baseline capacity compared to patients who were not in a prehabilitation program. The preoperative period may be an optimum time for prehabilitation since the recovery period post-surgery may not be the best time to introduce new health behaviours during the healing process. Prehabilitation research continues with the investigation of the optimum multi-modal approaches and timing for various health conditions, in preparation for surgery. Much evidence supports a combination of exercise, nutrition and psychological interventions to address the impending stress of any surgery. If you or someone you know has been recommended for surgery, ask the medical professional about prehabilitation options and recommendations to ensure that you, a family member or a friend, is in the best physical and psychological condition going into a successful operation followed by a speedy recovery or contact me at www.fitutoday.com to get you started. Source: 1Santa Mina, D. (2015). Optimization of Surgical Outcomes with Prehabilitation. Appl. Physiol. Nutri. Metab. 40: 966-969.