A new study suggests prehabilitation (prehab) can shorten hospital stays, minimise complications and enhance physical recovery and overall quality of life following surgery.
The comprehensive systematic review and meta-analysis – the largest to date – evaluated data from more than 15,000 patients across 186 randomised controlled clinical trials worldwide.
Researchers examined different types of prehab, including:
• Structured exercise
• Dietary improvements
• Psychological support
• Cognitive training
• Various combinations of these strategies.
Exercise emerged as the most beneficial intervention and nutritional enhancements were ranked second most promising.
Lead author Dr Daniel McIsaac, anaesthesiologist and senior scientist at The Ottawa Hospital and clinical research chair in perioperative innovation at the University of Ottawa, said: ‘If you are going to be having surgery, it is always a good idea to ask about prehabilitation. If you are willing and able to regularly increase your activity levels and protein intake for a few weeks before surgery, you are likely to experience a noticeably shorter recovery time after surgery.’
However, the study’s authors caution that many prehabilitation trials have been conducted in single hospitals, making it uncertain whether the findings will apply across diverse healthcare settings.
Dr McIsaac added: ‘Prehabilitation is very promising, but we still don’t know how best to implement it across hospitals and health systems. We’re pretty sure that if patients can do the work of prehabilitation, they are likely to benefit. The big question is how do we deliver prehabilitation that works for all surgical patients at a system level? Ongoing multi-centre trials should provide more rigorous evidence to support broader implementation.’
The research programme aims to develop a simple and practical approach to prehabilitation that can benefit the largest number of patients in meaningfully improving their surgical recovery and help patients get home faster after surgery.
Globally, more than 300 million surgeries are performed each year, with 20%-plus of major surgery patients experiencing post-operative complications. These complications can prolong hospital stays and slow down recovery.
Clinicians, researchers, and patient partners are guiding these trials through the Canadian Prehabilitation Knowledge Network and the Canadian Perioperative Anaesthesia Clinical Trials (PACT) Group.
Patient involvement is a priority, ensuring study results align with real-world patient needs and the broader healthcare system.The BMJPatient involvement is a priority, ensuring study results align with real-world patient needs and the broader healthcare system.
The study is published in The BMJ.
