By Crystal Mansfield, Grace Cottage Senior Director of Rehabilitation
Prehabilitation? Have you heard this word? In laymen’s terms, you might think of “prehabilitation” as preventive care, appropriate before hip or knee replacement, or any type of surgery.
What does prehabilitation consist of, and what are its benefits?
Generally speaking, prehabilitation is a proactive, therapeutic approach that can address deficits in strength, stability, range of motion, balance, and overall joint function in order to prepare for a surgery. In other words, they help get you in better physical condition before an operation.
Pre-operative conditioning and strengthening – also known as prehabilitation or “pre-hab” – helps to ensure you are in the best physical condition possible so that the post-operative rehabilitation is easier, leading to faster recovery. Using movement therapy and exercises, physical therapists (PTs) and occupational therapists (OTs) work with patients before surgery to improve function so the patient can withstand any post-operative inactivity and associated restriction of function.
Generally, patients are aware of the need for post-op rehab. Before surgery, the idea of getting into condition may seem abstract, not worth the effort. Research has proved otherwise.
A study reported by the National Institute of Health found that physical inactivity and poor fitness are among the major risk factors for any post-surgery complication. A team of British researchers explain this well in a journal article reviewing surgical data from the UK’s National Health Service. They write that, “The physiological challenge of major surgery has been likened to running a marathon … Preparation is critical. ‘Prehabilitation’ aims to enhance general health and wellbeing prior to major surgery. By intervening in the preoperative period … the ‘physiological reserve’ of the patient is enhanced to buffer the surgical stress response. Prehabilitation prepares individuals to ‘weather the storm’ of their operation and to avoid or overcome complications.”
The benefits of PT and OT both before and after surgery are clear. Pre-hab gets you into better shape, and rehab after surgery can speed your recovery, no matter what kind of operation you’ve had, be it a joint replacement, heart surgery, or a procedure to treat cancer.
PT and/or OT sessions often begin while you’re still in the hospital. A therapist will help you get out of bed and help you to start to walk again. You’ll also do other exercises to get you ready to go home.
After you’re released from the hospital, you might finish your recovery with a stay at a rehab center. Depending on the type of surgery you’ve had, you might be there for a few weeks or months. Sometimes a home health therapist will come to your home. Or your doctor may suggest you visit an “outpatient” center like Grace Cottage’s, which means you live at home but get therapy during regular appointments one or more times a week.
Even one or two sessions with a physical or occupational therapist after an orthopedic or other surgery can be helpful. Physical and occupational therapists show you how to care for yourself after surgery, including teaching you the appropriate exercises to be working on. Besides teaching specific exercises, we can keep you motivated and focused on your goals, both before and after surgery. Most Grace Cottage patients schedule once or twice a week for outpatient post-op therapies.
Another benefit of post-op rehab is that the therapist can offer ongoing encouragement. Post-op patients may encounter times of discouragement as they deal with pain and progress through their healing. PTs and OTs help to counter that. They can see your progress, and they will remind you of how far you have come. For most people, it’s much better than just doing it on your own. Everybody needs a motivating coach once in a while!
Most insurances cover both physical and occupational therapy; visit limits may apply but we work hard to give you the best outcome in the least number of visits possible. You may have to ask for a pre-hab referral, as its benefits are only recently being recognized.
Grace Cottage’s Rehabilitation Department, your primary care provider, or your surgeon can offer guidance or answer your questions about when rehab would be beneficial. Please call the rehab department at 802-365-3637, or contact your primary care office or surgeon.
