Prehabilitation for Surgery

Overview

An individual’s level of physical fitness significantly impacts multiple outcomes following a major surgery. Poor pre-surgery levels of fitness can lead to an increased chance of post-operative complications, increased length of intensive care unit (ICU) and hospital stays, and a slower return to everyday activities and a pre-surgery quality of life. 

Prehabilitation aims to improve patients’ physical activity tolerance (how much physical work your body can cope with) by steadily building up physical activity over the weeks leading to surgery, meaning you can return to normal as quickly as possible post-surgery. It is important to find ways to be active that work for you and are likely to be continued post-surgery to help rehabilitation.

Physical Activity & Prehabilitation

Research shows that increasing your physical activity levels is safe and feasible in the weeks leading up to major surgery. It can result in increased cardiorespiratory fitness and lung function, alongside many other benefits. Many patients can become deconditioned due to fatigue, poor appetite and poor nutrition because of their illness, meaning undergoing physical activity can be challenging, so prehabilitation focuses on increasing physical activity gradually in a sustainable way to produce the greatest health benefits. 

The Benefits of Physical Activity for Prehabilitation.

There are many benefits of being physically active both in the lead up to and following surgery, including:

  • Reducing the risk of post-operative complications
  • Reducing recovery time and length of hospital stay after surgery
  • Helping to improve and maintain muscle mass, strength, power, and balance, which can improve physical function and independence
  • Helping you to maintain a healthy weight or to lose weight, if needed
  • Helping to managing your blood pressure. 
  • Improving your circulation
  • Helping your joints and flexibility

Physical activity benefits your mind as well as your body. It is proven to reduce stress levels and improve low mood, and give you energy and help you sleep better, as well as improving your memory.

How do we Help Prehabilitation?

KiActiv® Health is a digital service that provides people with a personalised understanding of their everyday physical activity to empower behaviour change in the context of their health and capacity, enabling people to make the right choices for them. 

In the context of prehabilitation, it is important that individuals understand the impact that improving their physical health will have on their outcome and recovery from surgery, and that physical activity levels should be increased gradually depending on each individuals’ experiences of symptoms.

Crucial to this understanding is that physical activity is more than just exercise and sport, and that every move you make counts. Physical activity is defined as any bodily movement produced by skeletal muscles that results in energy expenditure and, as such, it is important that all of the movement in our lifestyles are accounted for – not just exercise.

Indeed, for many people awaiting surgery, physical activity is something that is often dreaded or feared due to a decline in physical function due to illness, and there is a common misconception that for physical activity to be valuable it must be vigorous. As such, understanding that physical activity is more than just exercise and sport, and that every move matters, is vital for empowering effective self-management. So, for individuals waiting for surgery, focusing on movements and lifestyle changes that are sustainable following their surgery can deliver the numerous benefits of physical activity and promote faster recovery.

Moving away from exercise to personalised, everyday physical activity is essential for prehabilitation, as it opens the therapy window to ~112 hours/week. This can feel more accessible to individuals pre- and post- surgery and this raised awareness and understanding of everyday physical activity is a key factor in increasing motivation to create healthier habits.

Here at KiActiv®, we have supported individuals to ‘wait well’ whilst waiting for treatment. We have worked with patients waiting for a major surgery to ensure they optimise their physical health and gradually improve their physical activity in a personalised way, resulting in a smooth recovery and continued self-management after surgery.

Importantly, by providing individuals with the knowledge, tools and support to self-manage, they can ensure they take it at their own pace, incorporating more activities into their daily routine as they feel ready, unlocking the numerous benefits to their health beyond recovery from surgery.

Client Quotes

“Overall its been great. Without it I would not have had the incentive to make the improvements I needed before my surgery. Looking forward to getting back on track when my knees have recovered.” 65, Male, Type 2 Diabetes & Knee Surgery

“In retrospect if I had not done the programme and become so much fitter I would not have coped with the surgery so well. The anaesthetist seemed quite impressed!”- 72, Male, COPD & Hypertension

“In a quiet way, you’ve boosted my confidence and made me realise it’s in my hands to improve my mobility.” 83, Female, RUH Cancer Prehab, (Colorectal Cancer)

“I don’t see any reason why any of this won’t continue up to and then post the operation. The people supporting me are really quite excited because they can see (the improvements) too.” – 52, Male, Obesity, Surgery & Lymphoedema

“Once the actual immediacy of the surgery is behind me, I will be looking to ultimately exceed what I have started over the past two months.”  – 52, Male, Obesity, Surgery & Lymphoedema