“Dura est manus cirurgi, sed sanans. The hand of the surgeon is hard, but healing”. Walter Map
What is Prehabilitation?
Prehabilitation( Prehab) is defined as a process of improving the functional capability of a patient prior to a surgical procedure so the patient can withstand any postoperative inactivity and associated decline. The goal of prehab programs is to help patients get into the best possible shape leading up to surgery. When you go into a procedure strong, it can take less work to recover afterward. More and more orthopedic surgeons are incorporating prehab exercise into patient treatment plans.
Check out this article!
Abstract
Introduction:
Osteoarthritis (OA) is the most common joint disease in the world. At the end stage of the disease, usually, when patients cannot handle the pain anymore, knee replacement surgery is the most common and effective treatment to reduce pain and improve functionality. The effect of preoperative exercise (prehabilitation) on patients undergoing total knee arthroplasty (TKA) is still controversial.
Aim:
To investigate the effect of prehabilitation on the postoperative outcome and compare the results of the intervention with the control group.
Material and Methods:
This prospective study included 20 patients with a diagnosis of gonarthrosis, aged 48-70, who were randomly allocated to either the intervention group or control. Ten patients (intervention group) underwent a 6-week home-based exercise program before the TKA surgery. All patients were assessed by Knee Score (KS), Function Score (FS), and Body Mass Index (BMI) according to the following schedule: 6 weeks before surgery (for intervention group it meant before the prehabilitation program), just prior to surgery (for intervention group it meant after the prehabilitation program), after the surgery, at 3rd month, 6th month, and 12th month postoperatively. They were all operated by the same surgeon, for the primary total knee replacement (Zimmer NexGen Complete Knee Solution) at the Clinic for Orthopaedics and Traumatology, Clinical Centre University of Sarajevo, from October 2016 to June 2017.
Results:
There is statistically significant difference for Knee and Function Score between the intervention and control group in testing time: just before surgery–meaning that KS and FS increased after the prehabilitation program. Knee Score was significantly different between the two observed groups postoperatively, 3 months postoperatively and 6 months postoperatively, while the Function Score was not significantly different in that period. Prehabilitation program provides better preoperative KS and FS, and better KS up to 6 months postoperatively. However, 12 months postoperatively there was no significant difference between the intervention and control group for the Knee and Function Score.
Conclusion:
Prehabilitation brings significant difference regarding the Knee Score in favor of the intervention group preoperatively and up to 6 months postoperatively
So to sum up the above article, having Prehab helps you recover quicker compared to not having 6 weeks of prehab. The patients were able to function and demonstrate better scores ( In pain and functional mobility) right after surgery, 3 months after surgery, and 6 months after surgery. It wasn’t until the 1 year mark that the 2 groups equalized! Can you believe it 1 year? Which course of action would you rather have?
What can Prehab Help with?
- Helps patients feel better and/or stronger and improves functioning before treatment.
- Prepares patients for the physical challenges faced following treatment.
- Improves patient psychological outcomes.
- Decreases hospital readmissions.
- Reduces health care costs
Cited Article:
Jahic D, Omerovic D, Tanovic AT, Dzankovic F, Campara MT. The Effect of Prehabilitation on Postoperative Outcome in Patients Following Primary Total Knee Arthroplasty. Med Arch. 2018 Dec;72(6):439-443. doi: 10.5455/medarh.2018.72.439-443. PMID: 30814777; PMCID: PMC6340623.
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