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Prehabilitation, or "prehab", means improving your fitness and health in the weeks before planned surgery so that you cope better with the operation and recover more quickly. Just as athletes train for an event, we can prepare your body for the stress of surgery — building exercise capacity, strengthening your breathing, and optimising nutrition and habits. The fitter you go in, the better you tend to come out.
Why prehabilitation matters
Surgery is a major physical stress. People who go into an operation with better fitness and stronger breathing muscles tend to have fewer chest complications, shorter hospital stays and a smoother recovery.1 The weeks before surgery are a valuable — and often wasted — window to make measurable gains, particularly before major abdominal, thoracic (chest), cardiac and cancer surgery.
What it involves
A prehabilitation programme is individualised after assessment, and usually combines several strands:
- Aerobic exercise — walking, cycling or interval training to build the cardiovascular reserve surgery demands.2
- Strength training — resistance work to preserve and build muscle before a period of enforced rest.
- Inspiratory muscle training — strengthening the breathing muscles, which reduces post-operative chest complications (see IMT).3
- Breathing and airway-clearance techniques — taught before surgery so you can use them confidently afterwards, when pain makes learning hard.
- Nutrition, smoking and alcohol — optimising these, with support to stop smoking, meaningfully lowers complication risk.
A typical pathway
References & evidence base
- Moran J, Guinan E, McCormick P, et al. The ability of prehabilitation to influence postoperative outcome after intra-abdominal operation: a systematic review and meta-analysis. Surgery 2016;160(5):1189–1201.
- Tew GA, Ayyash R, Durrand J, Danjoux GR. Clinical guideline and recommendations on pre-operative exercise training in patients awaiting major non-cardiac surgery. Anaesthesia 2018;73(6):750–768.
- Katsura M, Kuriyama A, Takeshima T, et al. Preoperative inspiratory muscle training for postoperative pulmonary complications. Cochrane Database Syst Rev 2015;(10):CD010356.
References are numbered in citation order (Vancouver/BMJ style) and were current at the time of writing. Guidelines are living documents — verify against the latest version before clinical use.
Physiotherapy around major chest, cardiac and upper abdominal procedures — from open surgery to bronchoscopic, catheter-based and bedside treatments — aims to reduce chest complications and shorten the return to normal function.
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