Study Shows that Prehabilitation May Aid in Recovery After Surgery

Oncology Nursing Society Newsletter reported results of a study showing benefits to patients who participated in “rehabilitation” weeks prior to their surgery.  Super news!

Oncology Nursing Society News Today
Prehabilitation Before Surgery May Aid Recovery
January 27, 2015

Patients are often told to follow a rehabilitation program after surgery, but a new study reported in Anesthesiology has found benefits to starting rehabilitation weeks before surgery.

The study included 38 patients who took part in a prehabilitation program—which involved starting exercising, eating a healthy diet, and learning relaxation techniques before colorectal surgery—and 39 who only did normal rehabilitation after surgery. The prehabilitation program lasted an average of 24 days and included 50 minutes of aerobic and resistance exercises at least three days a week, a personalized nutrition program with whey protein supplementation, and lessons in relaxation methods to help reduce anxiety. After surgery, both groups followed the same rehabilitation program.

At the start of the study, both groups could walk about the same distance in 6 minutes, about 425 meters. However, immediately before and two months after surgery, patients in the prehabilitation program could walk significantly farther than those in the other group. Two months after surgery, the prehabilitation group walked an average of 23.7 meters farther than when they started the study, whereas rehabilitation-only patients walked an average of 21.8 meters less than when the study started.

Which elements of the prehabilitation program were responsible for the improvement in recovery is not clear. Previous research used exercise only and found that patients assigned to structured aerobic exercise and strength training programs did worse than groups assigned to a walking and breathing routine, indicating that the diet and relaxation elements of the prehabilitation program may have contributed to the improvement in outcome. Both groups recovered from the surgery well, thanks to the use of minimally invasive surgical techniques. The groups had no differences in the rates of complications from surgery.

According to the authors, the study suggests that prehabilitation improves recovery outcomes by helping to prepare patients to withstand the stress of surgery so they are able to recover faster and function better after surgery. The researchers also cautioned that no cancer surgery or treatment should be delayed in an effort to gain the benefits from prehabilitation but that any amount time available can be used to participate in prehabilitation.

The researchers noted that that even without complications, patients receiving colorectal cancer surgery suffer from a 20%–40% reduction in functional capacity after surgery, particularly older adult patients and those with other health conditions who may not recover their presurgery functional level for several months, if at all. Targeting these patients may have a larger benefit compared to those in the present study. A larger study is planned to investigate patients at a higher risk for complications, including those whose function is deteriorating before surgery.

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