PREHABILITATION
WELL PREPARED FOR SURGERY
What would medicine be without basic knowledge, scientific interest, the courage to change things, new technologies and the famous ability to think outside the box? In this respect, a relatively new medical focus fits perfectly. This involves the exciting topic of "prehabilitation".
What does this imply? A lot can already be deduced simply from the meaning of the word. Prehabilitation is a made-up word from "pre" (before) and "rehabilitation" (restoration). It comprises a broad concept of measures, starting with a systematic test procedure, the patient screening, as early as possible before a planned, serious medical intervention. It has long been known that patients cope with serious surgical procedures in very different ways, both physically and mentally.
If one considers the general condition of the patient before surgery against this background, it is not uncommon to notice clear correlations (among others), for example, altered blood values such as special protein components, body weight and its progression, general muscle weakness or reduced resilience. Going for surgery in poor physical condition therefore obviously increases the risk of a significantly worse healing and recovery process. Would it therefore not be desirable to minimise the burden of necessary medical intervention through early, indication-based measures?
And this is precisely where prehabilitation comes in. Good preparation for a major operation demonstrably increases the chances of coping better with the stresses and strains of the procedure and recovering quickly1. After all, tumour patients in particular often show signs of pronounced weight loss at the initial consultation, often accompanied by a quantitative or also qualitative nutrient deficiency2. A logical consequence of this is the loss of strength and performance. At the same time, an exhausting operation, possibly with ventilation, awaits the patient.
Preparation on your own initiative
Targeted nutritional therapy, moderate strength exercises and breathing training could, for example, provide optimal preparation for the planned surgical procedure. But is there even enough time left before the operation? Or would a postponement for professional preparation be an alternative? Here, too, there are already clear results from scientific studies. Using the waiting time for surgery in a prehabilitative manner is crucial to noticeably improve the results and especially the quality of life of those affected. Even operations postponed in favour of prehabilitation can convincingly result in better patient performance afterwards3.
Have no fear, there is no overburdening of those affected in this field of medicine parallel to rehabilitation. Strength exercises do not immediately involve going to the gym. Dietary changes can be achieved, for example, with tasty special drinks, and a brisk walk can also be considered as breathing training. Regularity is of decisive importance, not only for the medical effect. The patients themselves particularly benefit from being able to influence the pre-operative phase on their own initiative with this concept. "It's in my own hands" often becomes the guiding principle of self-motivation. But it is precisely the joint interdisciplinary coordination of measures between patients, physicians and therapists that represents a medically sensible and important confidence-building approach.
In conclusion, it can be said that despite extensive medical interventions, there is a confident chance of noticeable success these days due to prehabilitation measures - and patients can be expected to leave the hospital faster afterwards.4
Tip: you can find even more information on the topics of exercise and nutrition in our blog "Small steps, big impact".
Sources:
1 Weisenburger L: Prähabilitation: Fit für die OP2022. Apotheken Umschau 2022, 01
2 Frank F, Kim M et al.: Outcome von Krebsoperationen: Prähabilitation ist so bedeutsam wie Rehabilitation. Deutsches Ärzteblatt 2022, Heft 37
3 Strous MTA, Janssen-Heijnen MLG, Vogelaar FJ: Impact of therapeutic delay in colorectal cancer on overall survival and cancer recurrence – is there a safe timeframe for prehabilitation? Eur J Surg Oncol 2019; 45 (12): 2295–301.
