Perioperative prehabilitation

Abstract

Perioperative prehabilitation has gained acclaim as a modality to improve outcomes in surgical patients, with evidence endorsing it. Although prehabilitation was originally confined to physical therapy, it now encompasses other domains of perioperative care, such as nutrition and psychology. This commentary is critical at this juncture to forge a holistic perspective on perioperative prehabilitation to guide clinical practice. The heterogeneity of currently available studies makes interpretation of the outcomes challenging, especially when further review of the literature reveals disparate findings. Studies show that benefits of preoperative physical therapy are confined to patients undergoing cardiac, thoracic and abdominal surgeries, with most studies showing no benefit in patients undergoing orthopaedic procedures. The literature implies that implementation of the domains of prehabilitation should be performed judiciously after careful selection based on patient characteristics, the nature of underlying disease and the surgery planned. Cost-benefit analysis of perioperative prehabilitation is yet to be performed.