The body is under a lot of strain after surgery. Patients are at risk for problems, which could delay healing. According to Katie Starr, chief scientific officer at Vivo and director of the VA POSH (Perioperative Optimization of Senior Health) program at the Durham VA Medical Center in Durham, North Carolina, taking the time to get in top physical condition before elective surgery can significantly increase a patient’s chances for a quick recovery.
In general, a person’s body is better able to combat the stress responses brought on by surgery the healthier they are before the procedure. However, a lot of people have weakened immune systems because of old age or a medical condition, which makes it more challenging for them to recover from surgery.
The medical profession is looking for ways to enhance patient outcomes after surgery as a result of an aging, obese, and diabetic population that is growing and increasing the need for surgical services.
Prehabilitation is one such method.
Prehab: What Is It?
Prehab is a new term in patient care that uses a proactive strategy to treat at-risk patients prior to elective surgery by employing exercise and diet training.
The majority of people are familiar with rehabilitation, a field of medicine that aids patients in regaining lost bodily capabilities as a result of illness or injury. For instance, individuals who have had hip replacement surgery typically need substantial rehab to aid in the recovery of their muscle strength, function, and mobility.
Prehab is similar to rehab before surgery in that it aims to get the body as healthy as it can be before the procedure so that the patient may recuperate quickly and get back to their regular activities. Prehab does, however, take some time. In just three weeks, cardiovascular improvements can be shown. But for patients to experience strength gains, prehab must last four to eight weeks before to surgery.
Where Does Pre-Rehab Originate?
Enhanced Recovery After Surgery was created in 1997 by a group of general practitioners from Europe in an effort to enhance patient postoperative results (ERAS). The approach uses procedures intended to shorten a patient’s stay in the hospital, their risk of complications, their recovery time, and their financial expenses.
The regimen has changed throughout time to incorporate procedures including pain treatment, nutrition advice, and patient and family education. The cornerstone of prehabilitation is enhancing patients’ health prior to surgery.
In order to delay and lessen the loss and impact [induced by surgery] so that they can recover sooner, Starr explains that the goal of prehab is to raise someone’s baseline from where they started.
How Does Prehab Function?
The kind of prehabilitation required depends on the operation type and the patient’s needs. Here are a few illustrations of how prehabilitation functions:
Building muscle mass helps patients undergoing joint replacement surgery move more freely and support their bodies as the affected area heals. This is done through the prehab process. For instance, an 84-year-old man had prehabilitation to fortify his upper body before to knee replacement surgery. His arm strength was the main focus of his prehab so he could lift himself onto and off of chairs and beds so he could put pressure on his repaired knee.
Cardiorespiratory: “When it comes to intubation under anesthesia, cardiorespiratory muscles are crucial. The lung’s reaction is severely impacted, “says Starr. Smokers, those with low lung volumes, and those with poor cardio-respiratory fitness are more susceptible to infection, pneumonia, and aspiration, which can all lead to long-term postoperative problems and impede the healing process after surgery.
Building aerobic capacity in addition to strength training may be the emphasis of rehabilitation for people having lobectomies or having a piece of their lungs removed.
Nutritional: Being nutritionally healthy prior to surgery is essential to a successful recovery since nutrition affects how quickly the body recovers from the stress of surgery, according to Starr.
Nutrition can suffer from a number of issues. Age-related physiological and metabolic changes in our bodies lead to a loss of muscle mass and renal function, which have an impact on fluid status and hydration. According to Starr, these changes are “important factors in regard to surgery because of the stress response.”
Additionally, the stress of surgery raises blood sugar levels, which puts patients who are not in good nutritional shape at danger. For instance, diabetes individuals who undergo surgery run the risk of complications such wound site infections and a protracted recovery.
Malnutrition can result from a person’s inability to eat food or absorb nutrients due to cancer or cancer therapies.
According to Starr, “we know that nutritional status is going to diminish in the hospital context, much like with function and cardiorespiratory and muscular function.” We want to make sure we take every possible step up front to assist limit that risk.
For Whom Is Prehab?
While being in excellent health before to elective surgery is beneficial for everyone, prehab is designed for patient populations that are more susceptible to the postoperative stress response, such as:
the elderly anyone with various health issues, such as Type 2 diabetes individuals with cancer at any age, especially those who have received radiation or chemotherapy.
According to Starr, those in superior physical health are less likely to benefit much from prehab. However, achieving peak health prior to surgery will result in “extraordinary benefits” for people who are physically unfit.
“Independence is one of the most crucial things for older individuals. They want to stay in their houses and maintain their independence. In order to do that, we must ensure that the muscles are optimized before the surgery, which includes both prehab and diet “says Starr. “That’s what we’re attempting to do: lessen the insult brought on by the operation and get them home, back to their normal activities, and back to their baseline as quickly as possible.”