Training for Surgery

There’s a term in the medical community that’s been floating around for about 10 years but is currently gaining recognition. "Prehab" is a word being used to describe the idea that patients who are going to undergo surgery can do something BEFORE the procedure that will have a significant impact on what happens after.

Just like athletes training for a race or an event, people who are facing surgical procedures can actually "train" before their surgery in order to improve their healing time. It seems like only common sense to say that healthy, strong patients fare better after surgery, but it’s a factor that’s often overlooked.

Michael Englesbe, a Michigan physician, along with several other colleagues, believes that preoperative preparation can decrease the length of time needed in the hospital after surgery, which in turn has the added benefit of reducing costs.

In February, for the third time, Englesbe’s group conducted a study of the data from the Michigan Surgical and Health Optimization Program (MSHOP). This organization offers patients basic fitness and wellness coaching before surgery. It helps patients target and strengthen areas of weaknesses so they can "Prehab" them. Diet, stress, breathing exercises, smoking cessation, and light physical activity are all analyzed and patients, along with their physicians and MSHOP design a plan of action for Prehab. Walking an hour a day with a pedometer is the predominant physical activity. Clients then receive daily emails or texts reminding them or prompting them to work to maintain their chosen program.

The medical journal Surgery published the most recent findings for patients participating in the MSHOP program.

• Hospital stays were reduced from seven to five days
• Costs were down 30%
• 641 participants had an 80% participation rate in their Prehab programs

Since 90% of all surgeries in the U.S. are elective, these results have far-reaching implications for the medical community and their patients. In addition to the physical benefits, MSHOP components also give patients a sense of empowerment in a situation that is nerve-racking at the very least. The emotional benefits that start in the days before surgery, can last well beyond.

The MSHOP curriculum was developed in Michigan five years ago and is being implemented in more than 20 hospitals and 30 practices. But it currently services only about 1,250 patients a year out of 65,000 surgeries performed. Although many approve of the idea, it’s difficult to change the current clinical culture and it puts more work on surgeon's plates. They’re the ones who have to initiate the conversation with their patients which only adds to an already heavy workload.

Prehab is, however, an idea that’s catching on with the insurance companies. They have a vested interest in reducing healthcare costs and their interest may help facilitate wider its use. It’s also believed that one day Prehab regimens could be tailor made for each surgery ensuring that each patient has the best possible chance to return to optimal health. Training for surgery may become an integral part of most surgical procedures in the future.