Prehab Revolutionizes Surgical Recovery: Faster Healing and Improved Quality of Life

Surgical recovery is no longer solely dependent on the procedure’s success. New research reveals that prehabilitation, or “prehab,” substantially improves recovery times, especially for older adults. This proactive approach involves a comprehensive program encompassing exercise, improved nutrition, psychological support, and cognitive training to optimize patients for faster recovery.

dr. daniel McIsaac, of the departments of anesthesiology and pain medicine at Ottawa Hospital, originally from Mermaid, P.E.I., played a key role in a recent systematic review of prehab published last month. This collaborative study with colleagues at the Ottawa Hospital research Institute, McGill University in Montreal, and St. Michael’s Hospital in Toronto,analyzed data from 15,000 patients undergoing planned surgeries.

The study’s findings highlight substantial benefits for prehab participants. “We’re seeing people get out of hospital a day or two sooner, wich is a pretty big impact, if you think about the number of surgeries and patients going through hospitals,” Dr. McIsaac told CBC’s Island Morning. The improvements extend beyond hospital stays: “Onc people are getting home, thay’re having a better ability to walk and get around and be autonomous at home, and whenever we ask them about their overall quality of life, they’re having really meaningful improvements in quality of life as well,” he added.

Why Prehab Matters

Dr.McIsaac’s interest in prehab stems from his experience as an anesthesiologist, witnessing firsthand the recovery struggles of many patients, especially older adults, after major surgery. He sought to understand how to improve outcomes for a broader patient population. He emphasizes that the process begins with a crucial decision: “Preparing for surgery starts with the most vital decision, he said: whether or not to proceed with the operation. He stressed the need for a thorough discussion with a surgeon about the potential benefits, risks and alternatives, calling that especially crucial for older patients with multiple health conditions.”

While the benefits of pre-operative exercise and improved nutrition seem intuitive, Dr.McIsaac notes that the stress of pre-surgical preparations—appointments, tests, and anxiety—frequently enough hinders patients from adopting healthier habits independently. This is where structured prehab programs become invaluable.“How do we get them to start exercising and keep exercising when they haven’t been already? How do we get them to change their diet and get a lot more protein into it?” he questioned. “People need help to make these big changes as they get ready for surgery during that stressful time.”

Accomplished prehab typically requires three to four weeks of commitment. Given current surgical wait times, this timeframe presents a valuable prospect for patients to engage in prehab. Christopher Wanczycki, who participated in a prehab program before colorectal cancer surgery in 2022, noted that the program “started with gradual exercises and levelled up — with support from a professional — over time.”

Integrating Prehab into Healthcare

Dr. McIsaac envisions prehab as a standard component of healthcare. His ideal scenario involves patients receiving prehab data and enrollment promptly after deciding on surgery. “Once they’re in that program, they’re going to need support on a fairly regular basis to check in and make sure that they’re doing their exercises… Some people may need to get sent into a gym for support. Some people can do that from home,” he explained. He also stresses the importance of nutrition, recommending “about a gram to a gram and a half of protein per kilogram of body weight a day. That way, their body is going to be better set to heal after the big surgery that they’re going to have.”

Dr. McIsaac and his team are conducting large-scale, randomized trials across Canada to further investigate prehab’s impact. Their aim is to present this data to health ministers and hospital leaders to advocate for the integration of prehab into standard surgical care, promising a future where faster recovery and improved quality of life are the norm for surgical patients.

Prehabilitation: The Key to Faster Recovery and Enhanced Quality of life After Surgery

Dr. Elaine Hanson, a renowned expert in prehabilitation, highlights the transformative impact of pre-surgical planning on patient outcomes. A surprising fact she shared is that: “individuals who engage in prehabilitation can leave the hospital up to two days sooner than those who do not.” This underscores the important shift in surgical recovery, particularly beneficial for older adults.

The Multifaceted Approach of Prehabilitation

Dr. Hanson explains that prehabilitation is a holistic approach encompassing tailored exercise programs, enhanced nutrition, and psychological support. She emphasizes the importance of increasing protein intake to about 1-1.5 grams per kilogram of body weight daily for tissue repair. Psychological support,including stress management techniques,helps maintain mental resilience during the often-anxiety-inducing pre-surgical period.

Overcoming Challenges in Prehabilitation

Addressing the challenges patients face in adopting lifestyle changes independently,Dr. Hanson highlights the role of structured prehab programs. These programs provide continuous support and regular check-ins, ensuring patients stay on track. The example of Christopher Wanczycki, whose program “started with gradual exercises and levelled up — with support from a professional — over time,” illustrates the effectiveness of this approach.

The Integration of Prehab into Standard Healthcare

Dr. Hanson envisions a future where prehabilitation is seamlessly integrated into standard surgical care. this requires systemic changes, including immediate data sharing and enrollment in prehab programs after a surgical decision. Collaboration among healthcare providers is crucial to create a smooth transition into these programs.

Key Takeaways for Patients and Healthcare Providers

• Holistic Approach: Prehabilitation involves exercise, nutrition, and psychological support.
• Supportive Environment: Structured programs provide continuous support and tailored interventions.
• Systemic Integration: Data sharing and immediate enrollment are critical for integrating prehab into standard care.

Dr. hanson concludes by emphasizing the promising future of prehabilitation, stating that “By prioritizing preparation before surgery, we are not only enhancing recovery times but also considerably improving patients’ quality of life post-surgery.”