Prehabilitation Before Surgery May Improve Recovery and Reduce Complications: Study
A new review published in The BMJ suggests that prehabilitation strategies—including exercise, nutritional support, and multicomponent interventions—may significantly improve surgical outcomes for adults undergoing major procedures. The findings highlight the potential benefits of targeted preoperative interventions in reducing complications, shortening hospital stays, and enhancing post-surgical recovery.
The study, led by Dr. Daniel I. McIsaac from the University of Ottawa, analyzed data from 186 randomized controlled trials involving 15,684 participants. The researchers assessed the impact of various prehabilitation components, including exercise, nutrition, cognitive training, and psychosocial support, on key surgical outcomes such as postoperative complications, hospital stay duration, health-related quality of life, and physical recovery.
Key Findings: Exercise and Nutrition Play a Crucial Role
The analysis revealed that exercise-focused prehabilitation, nutritional prehabilitation, and a combination of exercise, nutrition, and psychosocial support were the most effective in reducing postoperative complications compared to standard care. These interventions lowered the risk of complications by up to 50%.
When assessing hospital stays, the study found that exercise combined with psychosocial support, exercise combined with nutrition, and standalone exercise or nutrition programs were the most effective in reducing the length of hospitalization. The reductions ranged from nearly one to 2.5 days, depending on the intervention.
For improving health-related quality of life and physical recovery, the most beneficial approach was a combination of exercise, nutrition, and psychosocial prehabilitation. Among individual interventions, both exercise and nutrition were consistently linked to better overall outcomes across all key measures.
Aiming for Simpler and More Effective Prehabilitation Strategies
Commenting on the findings, Dr. McIsaac emphasized the importance of prehabilitation in enhancing recovery and helping patients return home sooner after surgery. “The goal of our research program is to develop a simple and effective approach to prehabilitation that can benefit the largest number of patients in meaningfully improving their surgical recovery,” he stated.
As surgical prehabilitation gains recognition, these findings reinforce the need for hospitals and healthcare providers to incorporate structured preoperative programs that include exercise and nutritional interventions. However, one of the study's authors disclosed ties to the nutrition industry, a factor that may warrant further scrutiny when interpreting the results.
With growing evidence supporting prehabilitation’s role in better surgical outcomes, these findings could influence clinical guidelines, encouraging more personalized, patient-centric approaches to preoperative care.