Prehabilitation – The science is in, isn’t it?

In medical circles, Prehabilitation is a relatively young concept (only ±20 years it seems), still subject to a slow uptake because “the science isn’t in”. According to a February 2016 article in PT in Action, “There's growing evidence that adding a "p" to rehabilitation improves patient outcomes pre- and postsurgery and following cancer treatments—and saves money, too.”

Invasive treatment programs and surgical procedures are some of the most gruelling experiences our bodies can endure, not in fact too dissimilar to the huge demands elite and amateur marathon runners place on their bodies for example. Yet, no-one in their right mind would suggest that ‘prehabilitation’ (a.k.a. a tailored training program) to assist the body to prepare and, importantly, recover was not a prerequisite to undertaking such a sporting feat.

So my question is: Isn’t the science already in?

It seems the NHS, often referred to as the world’s best healthcare system, is taking prehabilitation seriously with the release of an Elective Care Good Practice publication in which they suggest that patients not be referred to treatment until a risk assessment / fitness improvement has occurred. Interestingly, whilst they are putting their money where their mouth is with a refresh of existing Patient Decision Aids, there is no mention of what could be termed as Patient Activity Aids, aids that might educate and monitor patients in attaining the required fitness improvement (prehabilitation) for an improved health outcome.

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