Login | March 25, 2025
Efficacy of prehabilitation
PETE GLADDEN
Pete’s World
Published: March 24, 2025
Having undergone two orthopedic surgeries in the span of two years I’ve gotten a first hand perspective on this new thing called “prehabilitation.”
Now if you’re not familiar with the term, well, then consider yourself pretty lucky in that you likely haven’t undergone a surgical procedure in the last several years - because prehabilitation protocols are a relatively new concept.
Okay, so prehabilitation involves the exercises, PT (physical therapy), nutrition and/or anything else that you would be encouraged to do prior to a surgery in order to improve your chances for a successful operation as well as a prosperous recovery.
And this tactic has been gaining traction as an integral pre-surgical protocol to undertake over the span of the last couple of years.
So it should come as no surprise that a new study’s hit the press which has found that this tactic can have a ton of upside to it.
Upside indeed, for according to the study’s author, Dr. Dan McIsaac, a professor at the University of Ottawa, “We found evidence for prehabilitation efficacy with moderate effect sizes in reducing complications rates, and potentially clinically meaningful improvements in length of stay, health related quality of life, and physical recovery for adults preparing for major surgery.”
The aforementioned study, “Relative efficacy of prehabilitation interventions and their components: Systematic review with network and component network meta-analyses of randomised controlled trials,” was published in the Jan. 22, 2025 issue of BMJ (British Medical Journal).
In this study researchers wanted to explore the effectiveness of individual and/or combinations of prehabilitation elements (exercise, nutritional, cognitive, and psychosocial) on the success of postoperative outcomes.
And with respect to the outcomes, such factors as complications, length of stay, health-related quality of life, and physical recovery were assessed.
The study’s results are based on 186 unique randomized controlled trials that involved some 15,684 participants.
So primary among the findings in this study was one very critical revelation:That doing exercise prior to surgery looked to be an extremely promising protocol to employ.
Prehab was found to reduce the risk of complications by about 40%, in addition to decreasing the length of stays and making a noticeable difference in how patients experienced their recovery experience.
Another important discovery emerging from this study was the finding that prehab nutrition also plays a key role in the post-recovery process.
Here researchers found that the act of upping one’s protein intake prior to surgical procedures enhanced the patients recovery chances, especially with respect to individuals who are frail as a result of low muscle mass.
Now this finding can likely be explained by the fact that the body pulls protein out of muscle tissue to support the healing processes that occur post-surgery.
To counter this phenomenon research suggests that adding more high-protein foods, even for a couple of weeks prior to an operation, will help with recovery.
A third important finding to add to the list is that of pre-surgical mental preparation.
Now when they’re talking about mental preparation they’re talking about such acts as breathing exercises and even pre-surgical anxiety therapy, which involved stress management and/or anxiety management training.
So all of this brings us back to my own personal experience with respect to surgical prehabilitation.
Prior to my hip surgery for instance, I performed a twice-a-week exercise routine that focused on strengthening my operative hip and leg musculature for the upcoming surgery.
What’s more, the exercise was also intended to help to reduce the amount of muscle atrophy post-surgery due to the prescribed month-long ambulatory limitations I’d encounter.
And with respect to nutrition, I increased my protein intake for about a month pre-surgery via protein powder to help compensate for the protein that would be used by my body during the post-surgery healing process.
Now while putting together this column I came across an interesting NPR story that highlighted the concept of prehabilitation, and in it I found a very appropriate quote by one of NPR’s several interviewees.
Dr. Samir Sinha, a geriatrician at University Health Network in Toronto, had suggested to NPR that we ought to begin to look at prehabilitation as a process whereby we can prepare ourselves to be “battle-ready or game-ready” for our upcoming surgeries.
And well, in my case I can most definitely say that game-readiness was a big game-changer in my successful recovery from a major orthopedic operation.