Prehab

Prehab, short for prehabilitation, is a proactive approach to improving a patient’s health before a planned medical procedure or acute illness. The aim is to enhance physical and psychological readiness to reduce postoperative complications, accelerate recovery, and preserve function. Prehab may include exercise, nutrition optimization, medical optimization, and psychosocial support.

Core components typically include physical conditioning, such as aerobic and resistance training to improve cardiovascular fitness and muscle strength; respiratory exercises to reduce pulmonary complications; nutritional optimization with adequate protein, calories, and micronutrients; management of medical conditions (blood sugar, blood pressure, anemia); and psychosocial elements like education, expectation setting, and coping strategies. Delivery can be hospital-based, outpatient, or home-based, by a multidisciplinary team.

Programs are typically scheduled weeks before planned surgery to allow meaningful gains in fitness and nutrition. Timing and intensity vary by procedure, patient age, and baseline health. Systematic reviews report improvements in aerobic capacity and muscle strength, with reductions in complications and length of stay in some surgeries, though findings are heterogeneous and dependent on program quality.

Implementation considerations include tailoring to individual risk, monitoring progress, and ensuring adherence. Barriers include time constraints, costs, and limited access to multidisciplinary teams, which can create inequities. Advances in digital health and home-based programs seek to expand reach, though evidence on their effectiveness relative to supervised models varies.

Relationship to related concepts include enhanced recovery after surgery (ERAS) protocols, which emphasize perioperative care to reduce stress and speed recovery, and rehabilitation programs that continue after discharge. Prehab is distinct in focusing on the preoperative period as a means to improve postoperative outcomes.