The effect of a physical exercise and education prehabilitation program in general surgery patients

Deven Francis Wake

Background: Patients undergoing general surgery can often experience complication rates of 30-40% after surgery and can include post-surgical bleeding, pain, nausea, infection, and sepsis which can all significantly delay recovery. Prehabilitation enhances the physical function of patients prior to surgery to improve surgical outcomes and facilitate recovery. Previous research has explored the benefits of aerobic-based prehabilitation in improving recovery after surgery, however research into appropriately prescribed resistance focussed interventions is lacking. Resistance based exercise has the benefit of increasing muscle mass, muscle strength and physical function prior to surgery, enhancing recovery and return to pre-surgery function. This study explored the effects of a resistance-based prehabilitation program on overall patient recovery when compared to usual care. Methods: Seventeen participants (8 males and 9 females) were recruited via inpatient admissions and randomly assigned to an intervention group (n=9) receiving a pre-surgery resistance-based exercise program or usual care group (n=8) receiving standard patient education. The exercise program consisted of 6 resistance exercises targeting large major muscle groups with the focus of building muscle mass. Primary outcomes were length of stay (days) and post-operative complications. Secondary measures included; whole body resistance, isometric muscle strength, physical function, aerobic fitness, self-reported physical function and quality of life (QoL) and limb disability (upper and lower limb) Results: No differences were observed in length of stay between the prehabilitation and control groups (p=0.655). The control displayed a significant within group loss of 8.4kg in grip strength between pre and post-surgery (p=0.001), compared to the intervention group who only lost 0.8kg (p=0.776). Mental health summary score reported a significant difference between groups at six-week post-surgery (p=0.006) displaying increased quality of life as a result of the intervention. Conclusion: The preliminary results of this study indicate that resistance-based exercise training in the peri-operative period are associated with reported increases in patient mental health and isometric muscular strength.

The effect of a physical exercise and education prehabilitation program in general surgery patients

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