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June 21, 2022 6 mins

If rehab helps patients recover after a surgery, prehab helps patients get ready for that recovery beforehand. Learn how prehabilitation works in this episode of BrainStuff, based on this article: https://health.howstuffworks.com/medicine/surgeries-procedures/prehab-before-surgery.htm

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Speaker 1 (00:01):
Welcome to brain Stuff, a production of I Heart Radio,
Hey brain Stuff Lauren Vogle bomb here. Surgery can be
the best solution to a medical issue, but it puts
enormous stress on the body, and it puts patients at
risk for complications which can slow recovery. But it turns
out that there's a way to help. Prehabilitation or prehab,

(00:25):
and taking the time and effort to get into shape
before elective surgery can vastly improve a patient's chances for
a speedy recovery. Because the healthier person is before a surgery,
the better equipped their body is to overcome the stress
responses produced during the surgery. Rehabilitation is better known it's
the medical specialty that helps people regain lost functionality after

(00:47):
a medical event or injury. For example, people who have
undergone hip replacement surgery usually require extensive rehab to help
them rebuild muscle strength and regain function and mobility. Prehab
is like rehab before surgery. It strives to get the
body to its maximum health potential through exercise and nutritional
training so that the patient can more quickly heal and

(01:09):
return to normal activities after their surgery. Like rehab, though
prehab takes time. Cardiovascular improvements can be seen in as
little as three weeks, but four to eight weeks of
prehab before surgery is necessary for patients to see strength gain.
A prehab is sort of a buzz word right now,
but the idea has been in the works for at

(01:30):
least a couple of decades. In an effort to improve
postoperative outcomes of patients, a group of general physicians from
Europe developed a method called Enhanced Recovery after Surgery. It
employs practices designed to reduce a patient's hospital stay, complication rates,
recovery period, and economic costs. Through the years, the protocol

(01:52):
has evolved to include practices such as patient and family education,
pain management, and nutrition recommendations for the article this episode
is based on how Stuff Work. Spoke with Katie Starr
v VO, chief Scientific Officer with a v A Perioperative
Optimization of Senior Health at the Durham v A Medical
Center in Durham, North Carolina. She said, what we want

(02:13):
to do with prehab is bump somebody's baseline from where
they started so that we can delay and reduce the
loss and impact caused by surgery, so they'll be able
to recover sooner. The type of surgery and the patient's
needs dictate the type of prehab needed. For example, prehab
is often used in patients undergoing joint replacement surgery to

(02:34):
build muscle mass in order to better support the body
and provide mobility as the affected area recovers. So before
knee replacement surgery, prehab might be used to strengthen the
patient's upper body. It may focus on their arm strength
so the patient can lift themselves in and out of
chairs in their bed until it's safe to apply pressure
to the rebuilt knee. There's also cardio respiratory prehab. A

(02:57):
Star explained cardio respiratory muscles are extremely important when it
comes to intubation during anesthesia, the impact on the lungs
is very big. Strength training for those muscles and building
aerobic capacity can help improve cardio respiratory fitness, which helps
lessen the risk of infection, pneumonia, or aspiration after surgery,

(03:18):
all of which can cause long term complications. Meanwhile, nutrition
impacts how quickly the body heals from the stress of surgery,
which is why being nutritionally fit before undergoing surgery is
imperative to a good recovery. STAR set many conditions can
adversely impact nutrition. As we age, our bodies go through

(03:39):
physiological and metabolic changes that result in a loss of
muscle mass and renal function, which can affect hydration and
fluid status. Surgical stress also boosts blood sugar levels in
the body, opposing risks for patients who have diabetes, including
wound site infections and longer recovery. Cancer and cancer treatments

(03:59):
can also affect the person's ability to eat food or
absorb nutrients, which can lead to malnutrition. A Star said,
just like with function and cardio respiratory and physical function,
we know that nutritional status is going to decline in
the hospital setting. We want to make sure we do
everything we can on the front end to help mitigate

(04:20):
that on the back end. While anyone would benefit from
getting in optimal health before elective surgery, prehab is intended
for patient populations who are more vulnerable to surgical stress response,
including elderly people, anyone with pre existing conditions like diabetes
or autoimmune disorders, and patients with cancer, particularly those who

(04:41):
have undergone chemotherapy or radiation treatment. Star said, we're trying
to reduce the insult caused by surgery and get patients
home and back active and back to their baseline as
soon as possible. A prehab isn't a magic wand surgery
is always hard on the body and you have to
put in the work. But studies have shown enough evidence

(05:03):
to support the benefits of prehabilitation that the American College
of Surgeons has launched a program called it Strong for Surgery,
focused on identifying and evaluating evidence based practices aimed at
optimizing the health of patients before they go under the knife.
As always, I'm not a medical expert, so if you
are someone you love is preparing for surgery and is

(05:24):
curious about prehab, talked to an actual medical expert like
your doctor. Today's episode is based on the article prehab
could make your recovery from surgery a bit Easier on
how staff works dot com, written by Jennifer Walker. Journey
Brainstuff is production of I Heart Radio in partnership with

(05:45):
how stuff Works dot Com, and it's produced by Tyler Klang.
Four more podcasts from my Heart Radio, visit the I
heart Radio app, Apple Podcasts, or wherever you listen to
your favorite shows.

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