A new clinical trial has found that prehabilitation, also known as prehab, can help reduce disability after surgery in frail older adults if they are able to fully participate in the program. The findings were published in JAMA Surgery.
The study was conducted by researchers at The Ottawa Hospital and the University of Ottawa. It involved 847 older adults with frailty from 13 surgical centers across Canada. Participants were divided into two groups: one received a structured home-based prehab program focusing on exercise and nutrition for at least three weeks before surgery, while the control group received publicly available guidelines for physical activity and healthy eating.
The results showed that participants who completed at least 75 percent of the prehab exercises had significantly lower levels of disability after surgery. However, when looking at all participants, there was no difference in surgery-related complications or overall disability between the two groups.
The prehab program included personalized exercise and nutrition plans, instructional videos, an elastic band for strength training, a pedometer to track steps, coupons for protein supplements, and weekly calls from a prehab coach.
Christopher Wanczycki, who took part in the trial before his cancer surgery at The Ottawa Hospital, shared his experience: "A cancer diagnosis is never easy, and I can't imagine what my recovery would have been like without this program," says Christopher. "My surgery was on a Monday. By Wednesday, I could sit in a chair to eat lunch. On Thursday, I had dressed myself and was up at the nursing station trying to check myself out. By Friday, I was climbing the stairs at home. That would not have been possible without the prehab program."
Each year over 300 million surgeries are performed globally. More than 20 percent of major surgery patients experience complications that can prolong hospital stays and delay recovery; older adults with frailty are especially vulnerable.
A review published earlier this year found that prehabilitation may reduce complications and hospital stays after surgery while improving quality of life and physical recovery.
Despite growing interest in incorporating prehabilitation into healthcare systems, there are still questions about how best to implement it. Researchers at The Ottawa Hospital's Aging Innovation In Perioperative Medicine & Surgery (AIMS) Research Group are now conducting a new study called STRIVE to make virtual prehab programs more accessible across Canada. This initiative offers exercise, nutrition guidance, psychosocial support, and uses an online platform to assist patients.
