If you’re on a waiting list for surgery or have had an operation postponed for any reason, there may be something you can do right now to make use of that waiting time and help improve your post-operative outcomes.
Prehabilitation is a strategy that uses exercise to improve a patients’ physical capacity before surgery in order to achieve better outcomes afterward. It’s just like training the body for a race or other physical challenge. You wouldn’t run a marathon without training and preparation, so why wouldn’t you do the same for major surgery?
Prehabilitation is increasingly recommended for those facing all types of surgeries, and it’s improving outcomes and experiences for patients across a wide range of situations.
There’s no guarantee, of course, but it does offer you a chance to take some control over your situation, and it’s never a bad idea to do what you can to lower your risk of complications following surgery.
Post – Op Risk
Statistically, dying within a month after an operation accounts for almost 8 per cent of deaths globally, which makes it one of the top three factors contributing to global fatalities, trailing only heart attack and stroke.
While death is the most severe outcome, patients are also susceptible to a whole range of post-operative complications such as intense fatigue, fever, pneumonia, infection as well as many others, leading to longer hospital stays or hospital re-admittance. Those most at risk of post-operative complications are generally older adults that already live with other chronic diseases, take various medications and have a lower fitness level.
The success of a surgical procedure depends on more than the skill of the medical staff and the complexity of the operation. It is becoming apparent that the likelihood of the patient returning to health is also dependent on what they do in the weeks leading up to the surgery.
Doctors are often concerned with a patients’ risk factors- things like high blood pressure, obesity, blood lipid status and cardio-vascular fitness -many of which are difficult to alter in the short term. But in the medium to long-term, many of these risk factors can be positively impacted by exercise. Even a small amount of training and exercise can improve your physical fitness in as little as two weeks, making it a viable option for people preparing to undergo a surgical procedure.
Scientists have shown that an effective way of increasing your chances of successful recovery is to physically train in the time leading up to a surgery. In this era of long waiting lists, prehabilitation is one way to use that time effectively and an opportunity to improve outcomes.
The concept of prehabilitation is based on the idea that patients with a higher functional capacity, or fitness level, will better tolerate a surgical procedure, have fewer post-operative complications and demonstrate better functional, psychological, social and surgical outcomes.
Scientific evidence suggests that an individual’s fitness level may be a stronger predictor of post-operative risk than traditional risk factors, as small improvements in fitness have been associated with substantial improvements in survival.
The great news is that we know that many types of exercise are effective, including brisk walking or jogging, high-intensity interval training, weightlifting, breathing exercises as well as muscle or joint-specific training.
A Whole Body Approach
Like training for a race or sporting event, prehabilitation programs are most effective when combined with good nutritional and psychological preparation.
Surgery induces a stress response in the body causing an increased need for additional energy sources, this means that having the right pre-surgery diet is very important. You many need to change the way you eat by limiting fats, including more protein and taking supplements.
Preparing for the mental impact of surgery is also important. Seeking information and addressing anxieties regarding outcomes and pain management can lead to a better post-op response.
Basic lifestyle changes like quitting smoking and reducing alcohol consumption, have been shown to independently decrease the risk of postoperative complications.
Over-all, the best results have been observed when a multi-pronged approach, designed to address all aspects of a patient’s health, has been applied.
If you are currently on a waiting list for surgery speak to your GP or medical team about advice for prehabilition. You may find there are existing programmes you can avail of or alternatively you can get advice about how best to prepare for your specific procedure.
Written by Emily C. Dunford, Postdoctoral Fellow in Kinesiology, McMaster University. This article is republished from The Conversation with additional content from Greysnet.