Prehabilitation reduces surgery complications, shortens hospital stays, and improves recovery outcomes.
Preparing for major surgery by focusing on physical activity and a healthier diet—a practice often called prehabilitation—has shown promising results in helping adults recover more effectively. Studies indicate that those who adopt these practices experience fewer complications, shorter hospital stays, and improved quality of life post-surgery.
Dr Daniel McIsaac, anaesthesiologist and senior scientist at the Ottawa Hospital and clinical research chair in perioperative innovation at the University of Ottawa, explained, “We know that people who are more physically fit tend to recover faster from surgery and suffer fewer complications. While many patients, with encouragement from their doctors, want to improve their fitness before surgery, patients often aren’t sure where or how to start.”
Considering this, in a recent study, a research team analyzed numerous clinical trials to understand the impact of prehabilitation. They reviewed data from 186 studies involving over 15,000 participants, all preparing for various types of major surgery. The participants—with an average age of 62 and nearly equal representation of men and women—were assessed based on pre-surgery programs focused on exercise, nutrition, or a combination of strategies, compared to usual care. These programs were followed for at least a week before surgery.
The findings revealed that exercise alone could, in fact, significantly reduce the likelihood of post-surgery complications by as much as 50%, while nutritional support cut the risk of complications by 38%. When exercise, nutrition, and psychosocial support were combined, the risk dropped by 36%. And pairing exercise with psychosocial support reduced hospital stays by over two days, while combining exercise with nutrition shaved off about a day. The individual benefits of exercise and nutrition alone were also notable in the results, each contributing to slightly shorter hospital stays.
In addition to reducing complications and recovery time, prehabilitation appeared to boost physical recovery and overall quality of life after surgery. Combining different approaches, such as exercise and nutrition or adding psychosocial support, yielded the most significant improvements across various outcomes.
The team summarized, writing, “Consistent and potentially meaningful effect estimates suggest that exercise prehabilitation, nutritional prehabilitation, and multicomponent interventions including exercise may benefit adults preparing for surgery and could be considered in clinical care. However, multicenter trials that are appropriately powered for high priority outcomes and that have a low risk of bias are required to have greater certainty in prehabilitation’s efficacy.”
Despite these promising findings, the researchers emphasized that the evidence quality varied, and some studies were prone to biases or inconsistencies. However, even after excluding higher-risk trials, the benefits of exercise and nutrition remained consistent. This suggests that prehabilitation can be a valuable part of preparing for surgery, especially when tailored to an individual’s needs.
The takeaway is clear: taking time to get stronger and healthier before surgery can make a difference. While more research is needed to refine these programs and determine the most effective combinations of interventions, the evidence so far suggests that exercise and good nutrition are key steps anyone can take to prepare for major surgery and improve their chances of a smoother recovery.
Sources:
Exercise and eating better prior to surgery cuts complication risks – study
Prehabilitation associated with fewer complications and improved recovery after surgery
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