Prehabilitation in Preparation for Orthopaedic Surgery

Abstract

By improving an individual's functional capacity through increased physical activity before an anticipated orthopaedic procedure, it seems reasonable to assume that the individual will maintain a higher level of functional ability and rebound more rapidly in the rehabilitation process. Prehabilitation is the process of enhancing functional capacity of the individual to enable him or her to withstand the stressor of inactivity associated with an orthopaedic procedure. A generic prehabilitation program incorporates the components of warm-up, a cardiovascular component, resistance training, flexibility training, and practicing functional tasks.

Drug-Related Problems in Patients Undergoing Elective Total Joint Arthroplasty of the Hip or Knee

“…Prehabilitation has been described as the enhancement of a patient's functional capacity, to enable the patient to withstand surgery. 6 Optimization of a patient's medication therapy is one area where postoperative outcomes can be improved through preoperative assessment and management. 7 It has been well established that the clinical activities of pharmacists improve patient care in the surgical setting [1][2][3][4][5] and other patient care areas, 8 which could include preadmission and prehabilitation.…”

Promoting a culture of prehabilitation for the surgical cancer patient

“…As many cancer patients are old with several comorbidities besides physical inactivity, at nutritional risk and not in appropriate health to sustain the stress of tumor resection, it would make sense to augment functional capacity through, for instance physical, nutritional and mental conditioning in anticipation of surgery. Topp [11] and Ditmyer [12] have proposed that, by applying a presurgical exercise program in patients, to improve functional ability before a stressor such as surgery, postoperative recovery would occur more rapidly compared to patients who remain inactive through surgical admission ( Figure 1). The present narrative review has been written with the intention of the authors to convey concepts of prehabilitation within the context of the ERAS program.…”

Preoperative Strength Training for Patients Undergoing High Tibial Osteotomy: A Prospective Cohort Study With Historical Controls

“…30,44 Preoperative exercise, sometimes termed "prehabilitation," is theorized to improve functional capacity of the body in preparation for the stressful event of surgery. 14 Preoperative gains in muscular strength may be useful prior to orthopaedic surgeries that require prolonged periods of reduced mobility postoperatively. We have previously shown that patients awaiting HTO can participate in a highintensity resistance training program and achieve substantial gains in quadriceps and hamstrings strength without increasing symptoms.…”