Prehab is the best way to ensure patients fully recover from major surgery, according to a new study.
Optimizing exercise and nutrition before going under the knife — known as prehabilitation or "prehab" — boosts patient recovery, say doctors.
Programs that support patients' health before surgery reduce the length of hospital stays and post-op complications, reveal the findings of a major review.
Prehab — care provided before surgery to improve health — is an emerging approach in medicine.
It provides patients with exercise, nutrition, psychological support and education to help patients prepare for surgery and recover more quickly.
The review of more than 20 previous studies found that prehab reduced complications after surgery by almost half and shortened hospital stays too.
Researchers from the University of California, Los Angeles (UCLA) reviewed 23 controlled trials involving more than 2,100 patients who participated in prehab programs focused on improving physical health through exercise and nutrition optimization.
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The research team evaluated how prehab affected hospital length of stay, complications within 12 weeks after surgery, and other outcomes, including quality of life and mental health.
Eighteen of the studies involved exercise interventions, while five used nutrition-based approaches.
Prehab reduced post-op complications by 48% and shortened hospital stays by 11%.
Exercise programs lowered the risk of complications the most, according to the findings.
Patients who participated in exercise-based programs had a 55% lower chance of complications compared with standard care.
The programs included strength or interval training and lasted from two weeks to six months.
Around two-thirds of the exercise-based prehab interventions were conducted under direct clinical team supervision, while 33% were unsupervised and required participants to document compliance in a logbook.
Nutrition-focused programs were more effective at shortening hospital stays, reducing time spent in hospital by around 14% compared with standard care.
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The programs typically lasted from five days up to two weeks and often included specialized nutritional supplements designed to support the immune system and recovery.
Exercise programs were also linked to better overall well-being and daily functioning, although they did not significantly reduce pain or improve emotional health after surgery.
First author Dr. Catherine Cascavita, of UCLA, said: "Both nutritional and exercise-based prehabilitation programmes can improve recovery after surgery, but each may offer different benefits.
"More research is needed to determine which type of programme works best for individual patients and their specific surgery."
Senior author Dr. Justine Lee, of UCLA David Geffen School of Medicine, said: "These findings support the value of prehabilitation programs in optimizing health for patients, especially those who are at high risk of facing complications or who may benefit from extra support before undergoing surgery."
She says future research will focus on making prehab more widely available, standardizing protocols, and reducing barriers such as cost and insurance coverage.
Lee's research group is actively developing specialized prehab programs for patients undergoing facial reconstruction surgery.
She added: "We are just beginning to understand how we can improve surgical outcomes before a patient has surgery."
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