prehabilitation

{{Short description|Medical term}}

Preoperative rehabilitation, prehabilitation or prehab, is a form of healthcare intervention that takes place before a medical or surgical intervention with the aim to reduce side effects and complications, and enhance recovery.{{Cite journal |last1=Wynter-Blyth |first1=Venetia |last2=Moorthy |first2=Krishna |date=2017-08-08 |title=Prehabilitation: preparing patients for surgery |url=https://www.bmj.com/content/358/bmj.j3702 |journal=BMJ |language=en |volume=358 |pages=j3702 |doi=10.1136/bmj.j3702 |issn=0959-8138 |pmid=28790033|s2cid=29658090 }} Multidisciplinary team involvement can range from physiotherapists, occupational therapists, respiratory therapists, doctors, pharmacologists, anesthesiologists, psychologists, psychiatrists and sports physiologists.{{Cite web |date=30 Nov 2020 |title=Principles and guidance for prehabilitation within the management and support of people with cancer |url=https://cdn.macmillan.org.uk/dfsmedia/1a6f23537f7f4519bb0cf14c45b2a629/1532-source/prehabilitation-for-people-with-cancer-tcm9-353994 |website=Macmillan Cancer Support}}

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.

Prehab is also being considered for use in some cardiovascular interventions,{{cite journal |vauthors=Alkarmi A, Thijssen DH, Albouaini K, etal |date=June 2010 |title=Arterial prehabilitation: can exercise induce changes in artery size and function that decrease complications of catheterization? |journal=Sports Medicine |volume=40 |issue=6 |pages=481–92 |doi=10.2165/11531950-000000000-00000 |pmid=20524713 |s2cid=24870534}} and may also be of some benefit for preventing lung complications, such as pulmonary atelectasis, in general surgery.{{cite journal |vauthors=Jack S, West M, Grocott MP |date=September 2011 |title=Perioperative exercise training in elderly subjects |journal=Best Practice & Research. Clinical Anaesthesiology |volume=25 |issue=3 |pages=461–72 |doi=10.1016/j.bpa.2011.07.003 |pmid=21925410}}

For older people with frailty undergoing abdominal surgery, prehabilitation programmes that include exercise, improved diet and psychological support can reduce the length of hospital stay and decrease the risk of serious complications.{{Cite journal |last=Skořepa |first=Pavel |last2=Ford |first2=Katherine L. |last3=Alsuwaylihi |first3=Abdulaziz |last4=O'Connor |first4=Dominic |last5=Prado |first5=Carla M. |last6=Gomez |first6=Dhanny |last7=Lobo |first7=Dileep N. |date=2024-01-22 |title=The impact of prehabilitation on outcomes in frail and high-risk patients undergoing major abdominal surgery: A systematic review and meta-analysis |url=https://linkinghub.elsevier.com/retrieve/pii/S0261561424000153 |journal=Clinical Nutrition |language=en |volume=43 |issue=3 |pages=629–648 |doi=10.1016/j.clnu.2024.01.020}}