Home E-Weekly April 25, 2017

Prehabbing Produces Better Surgical Outcomes

Published: April 24, 2017

ON THE MOVE Light walking improves blood flow and speeds healing.

Patients who walk an hour a day in the weeks leading up to surgery recover from surgery faster and help lower overall healthcare costs, according to University of Michigan researchers, who say convincing patients to adopt healthy lifestyles should be given the same priority as other pre-op protocols.

The researchers recently assessed the outcomes of 641 patients who underwent elective procedures after participating in the Michigan Surgical and Health Optimization Program (MSHOP), a home-based program created at the University of Michigan to help patients become physically and mentally stronger before undergoing surgery. Patients were asked to complete light physical activity, eat healthy, reduce their stress levels, complete breathing exercises and quit smoking. The program reduced length of post-op hospitalizations by 2 days and sliced a third off the cost of care, according to the study.

Patients received daily positive reminders via text or automated phone calls to complete the walking regimens. The intervention contributed to 82% of the patients being actively engaged in the program, meaning they recorded physical activity at least 3 times per week, according to the researchers.

Physical and mental strength dictates how well patients recover from the controlled injury of surgery, according to Stewart Wang, MD, PhD, FACS, one of the creators of MSHOP and co-author of the study. But despite the positive impact that prehabbing has on post-op results, concerns about the amount of work it takes to implement the regimen have prevented more surgeons from embracing the concept. That hasn't deterred the Michigan researchers, who say MSHOP is scalable and could be tailored to address the prehab needs of individual patients undergoing specific procedures such as joint replacement surgery.

"Expected complications or recovery difficulties could be addressed in advance with targeted training," says Dr. Wang. "This is just the beginning."

Daniel Cook

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