Posted on January 15, 20141
By Cari Kelly, PT, DPT
If you have had an experience with physical or occupational therapy, you know that rehabilitation is the process of regaining lost motion, strength and function following injury or surgery, but what about preserving that loss prior to surgery through prehabilitation?
Prehabilitation, or “pre-hab”, is the process of enhancing functional capacity prior to surgery to enable you to better tolerate the period of inactivity that comes with undergoing surgery. It is designed to help strengthen the muscles and tissues in order to make post-surgery recovery faster and more effective.
In prehabilitation, like rehabilitation, you work towards building muscle strength, correcting muscle imbalances, increasing efficiency of movement patterns, enhancing joint mobility, flexibility and proprioception (the ability to sense position and movement). Working on these skills prior to surgery has been found to offset the deconditioning that often occurs secondary to decreased activity that often occurs when you are in pain prior to and following surgery.
Recent studies have focused on the effectiveness of prehabilitation prior to knee surgery. For many knee surgeries, preoperative function, especially of the quadriceps muscle, is one of the greatest overall predictor of postoperative function, especially for those undergoing total knee replacements and knee ligament reconstruction.
One study performed by Swank et al in 2011 found that a 6-week prehabilitation program prior to knee replacement resulted in greater quadriceps strength, faster walking speed and greater mental health than those who did not receive prehabiliation. Another study by Topp et al in 2012 found that those who completed a prehabilitation program prior to knee replacement surgery had significantly greater strength at 12 weeks following their surgery than those who did not.
Another study looking at the effects of prehabilitation prior to total knee replacement found that patients who completed 4-8 weeks of prehabilitation, at least 3x/week showed stronger leg strength, increased walking speed, decreased time to ascend stairs and perform sit to stands.
Similar studies on ACL knee ligament reconstruction have found that patients who undergo prehabilitation, in addition to rehabilitation following surgery have stronger quadriceps strength, improved knee function and faster return to sport times.
Overall, prehabilitation has been found to result in greater strength, lower pain, increased improvement rates, more rapid return to regular activities and decreased time in post-operative physical therapy for many conditions. While not everyone may be a candidate for prehabilitation, consider it as an option to help facilitate better rehabilitation results following surgery.