Prehab before a knee replacement, new Canadian research findings

The Benefits of Prehabilitation Before Surgery: A Simple Overview

(find research info at the bottom)

Undergoing surgery can be daunting, and the recovery process often feels like a long and difficult journey. But what if there were ways to make this process easier and faster? That’s where prehabilitation comes in. Prehabilitation is about preparing the body and mind for surgery through exercise, nutrition, and mental well-being. A recent review of 186 clinical trials involving over 15,000 participants aimed to assess how effective different prehabilitation methods are for improving recovery after surgery. Here’s a summary of what they found.

What Is Prehabilitation?

Prehabilitation is a series of activities designed to prepare patients for surgery. The main components are:

Exercise: Strengthening the body to improve fitness and endurance.

 Nutrition: Ensuring the body is well-nourished and ready for surgery.

Cognitive and Psychosocial Support: Helping manage stress and anxiety through mental health support.

The purpose of prehabilitation is to improve the chances of a smoother recovery post-surgery, reducing complications and speeding up healing.

Key Findings from the Study

1. Reduced Complications After Surgery

The study found that prehabilitation especially when it involved exercise, nutrition, and psychosocial support was likely to reduce complications after surgery. Even simpler interventions like just exercise or nutrition were linked to fewer complications compared to usual care, though the evidence on this was a bit uncertain.

2. Shorter Hospital Stays

Prehabilitation also seemed to help shorten the time patients spent in the hospital after surgery. Combining exercise with psychosocial support was most effective at reducing hospital stays, while exercise alone and nutritional support also helped decrease the duration of hospitalization.

3. Improved Quality of Life and Physical Recovery

Patients who participated in prehabilitation programs, particularly those including exercise, nutrition, and psychosocial support, had better physical recovery and quality of life. For example, these patients walked farther in a six-minute test, indicating quicker physical recovery. They also reported improvements in their overall well-being after surgery.

4. Which Components Are Most Effective?

The study found that exercise and nutrition were the most helpful components when used individually. Together, these elements had the most significant positive effect on recovery outcomes.

Why This Matters

The results suggest that preparing for surgery with prehabilitation particularly through exercise and good nutrition can have a big impact on how well a patient recovers. Although some of the evidence from the trials is uncertain due to flaws in the studies, the overall findings are promising.

While more high-quality research is needed to confirm these benefits, the existing data makes a strong case for incorporating exercise, nutrition, and mental health support into pre-surgery care. If you are preparing for surgery, this could be an important step to improve your recovery process.

Conclusion

If you or someone you know is about to undergo surgery, prehabilitation may be worth considering. Exercise, nutrition, and mental health support can all help improve recovery times, reduce complications, and boost overall outcomes. Although more research is needed, these early findings suggest that prehabilitation could be an easy and effective way to help ensure a smoother surgery and recovery process.

Before undergoing surgery, make sure to talk to your doctor about prehabilitation and how these strategies might be incorporated into your treatment plan. Preparing your body and mind beforehand can make all the difference in how quickly and well you recover.

Research

Relative efficacy of prehabilitation interventions and their components: systematic review with network and component network meta-analyses of randomised controlled trials

BMJ 2025; 388 doi: https://doi.org/10.1136/bmj-2024-081164 (Published 22 January 2025)

Cite this as: BMJ 2025;388:e081164

Daniel I McIsaac, anaesthesiologist, scientist, professor1, Gurlavine Kidd, patient author2, Chelsia Gillis, assistant professor3, Karina Branje, research coordinator2, Mariam Al-Bayati, research assistant2, Adir Baxi, research assistant2, Alexa L Grudzinski, anaesthesiologist4, Laura Boland, senior research analyst5, Areti-Angeliki Veroniki, scientist6, Dianna Wolfe, senior research associate2, Brian Hutton, senior scientist2