Prehabilitation is the work/effort done prior to surgery in order to reduce the amount of time needed for recovery after surgery. Prehabilitation has been an essential component of sports medicine for decades. Only recently though, has general medicine realized the benefits of prehabilitation.
Historically, patients have been instructed to rest and not exert themselves prior to surgery. Yet studies (such as Journal of Bone and Joint Surgery 10/2014) show that the use of pre-op physical therapy was associated with a 30% decrease in the use of post acute care services. The preoperative time frame may be the best time to exercise, since patients are generally in better physical condition compared to post-op.
Knowing patients strength, range of motion, and functional limits pre-op allows the physical therapist and patient to more accurately set post-op goals. Prehabilitation is not rigorous. It is designed to address, arrest and reverse the physical decline, muscle atrophy and decreased quality of life during and after the surgery.
Patients are instructed what to expect and do before and immediately after surgery to maximize healing, range of motion, strength, endurance and overall recovery. Patients who have been educated about their specific impairment, surgery and functional deficits, are more likely to participate in early activation of muscles and motion because they are less likely to be afraid to move/exercise–they have an increased sense of control.
The earlier a patient starts a controlled exercise program–especially prior to surgery—the more quickly they will regain range of motion, strength and function. It is also likely that prehabilitation will decrease post-op pain.