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June/July 2014 (vol. 11/1)
Prehabilitation may improve post-operative outcomes
Improving fitness before elective surgery, or ‘prehabilitation’, may increase post-operative fitness and reduce the length of the hospital stay, according to this systematic review and meta-analysis. Pre-operative physical conditioning, either using physiotherapy targeted at specific muscles or joints, or broader ‘whole body’ exercises (the focus of this review), is designed to enhance recovery, and although not specifically addressed in the review, could conceivably improve return-to-work outcomes. Most studies found that total-body conditioning improved post-operative pain and physical function, and reduced length of stay in hospital. A meta-analysis of nine studies found a significant small-to-moderate reduction in length of stay following total-body prehabilitation (p = 0.033). Evidence quality was rated poor to moderate, with several studies assessed as having a high risk of bias.
Effect of total-body prehabilitation on postoperative outcomes: a systematic review and meta-analysis. Physiotherapy 2014; online first: dx.doi.org/10.1016/ j.physio.2013.08.008
Occupational Health at Work June/July 2014 (vol. 11/1) pp44