As with most things in life it is best to be prepared. If you were to run a marathon you would probably follow a training plan to prepare your body for the physical challenge. Well surgery is not dissimilar to preparing for a sporting event – preparation makes all the difference. In fact prehabilitation predicts surgical success!

Although a lot of the work we do in the clinic is to help our client’s avoid surgery, sometimes surgery is the answer.  When that happens our focus shifts to preparing you for surgical success. It is becoming more known that fitness predicts better outcomes in a number of different surgical interventions (i.e. orthopedic, cancer, GI). This phenomenon is something we regularly see in the clinic. Our clients tell us what a difference preparing for surgery has made in all aspects of their surgical experience.

Why Prepare for Surgery

When you think about going into hospital for a surgical procedure, you may expect that you will participate in some form of rehabilitation or physical therapy after the surgery to help your recovery. The concept of ‘prehabilitation’ is to get ready before the surgery.  This new trend in health care is based on findings that patients with higher fitness levels, aka functional capability, are more likely to:

  1. better tolerate a surgical intervention
  2. withstand the stress of inactivity associated with the procedure
  3. have reduced postoperative complications
  4. have shorter hospital stays
  5. demonstrate better functional, psycho-social, and surgery-related outcomes
  6. maintain a higher level of functional ability
  7. rebound more rapidly in the rehabilitation phase

I think it is also important to note that engaging in activities to increase physical fitness promotes and facilitates health behavior changes, not only pre-operatively, but during the postoperative period and beyond. In other words, participating in prehabilitation allows you time to develop positive habits that you can continue after the surgery and over the long-term.

Goals of Preparing for Surgery

A basic prehabilitation program typically includes the following goals:

  • increasing your aerobic capacity
  • improving your overall muscle and core strength
  • increasing your flexibility
  • improving your awareness of post-operative movement patterns and protocols

Your Prehabilitation Program

To achieve these goals your program should include:

  • a warm-up
  • a cardiovascular component
  • resistance training
  • flexibility training
  • practice of every-day functional activities

It is not uncommon that patients going for surgery feel ill-prepared to design their own fitness plan. The complexity of knowing what to choose along with being sedentary from the effects of the injury can make this a challenge.   This is where consulting a fitness professional can be helpful. The ideal timing to begin is at least 6, and preferably 12 weeks before your elective surgery.

Your Therapeutic Fitness Team

At the Orthopaedic Therapy Clinic , John Gray R Kin and I have experience designing prehabilitation programs that reflect your individual needs.  They can be targeted specifically for the surgical procedure and reflect your medical status. We help clients prior to surgery to become stronger and fitter, improve their mobility and gain more awareness of how to do their post-op exercises correctly and effectively. We are committed to work with you to achieve optimal fitness before and after your procedure. Our approach is flexible and we can design programs that are performed independently in your own home or at your local gym.  If you prefer you can work with us on a one-on-one basis.

So if you were one of the many people who thinks it is best to wait to work on your rehab until after their surgery, I hope this article has changed your mind. If you have further questions or would like to book an appointment to prepare for surgery or achieve any other training and fitness goals please contact Claire Curtis at cmcurtis@orthophysio.com or 416-925-4687 .

References

  • Prehabilitation: preparing patients for surgery. BMJ 2017;358:j3702.
  • Optimization of surgical outcomes with prehabilitation. Appl Physiol Nutr Metab.2015 Sep;40(9):966-9.
  • The Impact of Fitness on Surgical Outcomes: The Case for Prehabilitation.Curr Sports Med Rep.2016 Jul-Aug;15(4):282-9.
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    By: Claire Curtis

    Dr. Claire M. Curtis 
    Kinesiology and Health Science PhD
    cmcurtis@orthophysio.com
    Claire graduated from Leeds Metropolitan University in the UK, in 1996, achieving a BA (Hons) in Human Movement Studies and a Post Graduate Certificate of Education (Physical Education). In addition to her formal educational training in England, she acquired several vocational qualifications, including medical exercise specialist and postural stability instructor. Claire moved to Toronto, Canada in 2003 and continued her educational path, acquiring an MA and then a Doctoral degree in Kinesiology & Health Science from York University. Claire brings her passion about health and well-being to the clients she works with. Her personable and caring approach helps empower people to make, and maintain, positive lifestyle changes .
    Claire sees clients at the Orthopaedic Therapy Clinic in downtown Toronto.
    She can be reached for appointments at 416 925 4687

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