Introduction to Prehabilitation

Pre-habilitation, prehabilitation, or “prehab” is the concept of using many traditional rehabilitation strategies to prepare for surgery or other major medical interventions such as chemotherapy. The premise is that by improving the individual’s health and functional status prior to the physical stress, the individual will have greater resilience, resulting in better outcomes. Many prehabilitation plans set tangible goals such as improvements in holistic measurements of function such as the 6-minute walk test (6MWT), weight loss of a certain amount, normalization of abnormal lab values such as blood glucose or liver enzymes, or improvement in respiratory function. These changes are associated with improved surgical outcomes such as reduced complication rates, shorter length of stay, and lower rates of reoperation, depending on the intervention they precede. Many surgeries—particularly orthopedic—often have body mass index (BMI) maximums and will refer patients who exceed these cutoffs for evaluation by a weight loss specialist prior to surgery [1]. In some cases, surgery is contingent upon achieving certain goals.