WEBVTT - How Does Prehab Work?

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<v Speaker 1>Welcome to brain Stuff, a production of I Heart Radio,

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<v Speaker 1>Hey brain Stuff Lauren Vogle bomb here. Surgery can be

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<v Speaker 1>the best solution to a medical issue, but it puts

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<v Speaker 1>enormous stress on the body, and it puts patients at

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<v Speaker 1>risk for complications which can slow recovery. But it turns

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<v Speaker 1>out that there's a way to help. Prehabilitation or prehab,

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<v Speaker 1>and taking the time and effort to get into shape

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<v Speaker 1>before elective surgery can vastly improve a patient's chances for

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<v Speaker 1>a speedy recovery. Because the healthier person is before a surgery,

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<v Speaker 1>the better equipped their body is to overcome the stress

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<v Speaker 1>responses produced during the surgery. Rehabilitation is better known it's

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<v Speaker 1>the medical specialty that helps people regain lost functionality after

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<v Speaker 1>a medical event or injury. For example, people who have

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<v Speaker 1>undergone hip replacement surgery usually require extensive rehab to help

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<v Speaker 1>them rebuild muscle strength and regain function and mobility. Prehab

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<v Speaker 1>is like rehab before surgery. It strives to get the

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<v Speaker 1>body to its maximum health potential through exercise and nutritional

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<v Speaker 1>training so that the patient can more quickly heal and

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<v Speaker 1>return to normal activities after their surgery. Like rehab, though

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<v Speaker 1>prehab takes time. Cardiovascular improvements can be seen in as

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<v Speaker 1>little as three weeks, but four to eight weeks of

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<v Speaker 1>prehab before surgery is necessary for patients to see strength gain.

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<v Speaker 1>A prehab is sort of a buzz word right now,

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<v Speaker 1>but the idea has been in the works for at

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<v Speaker 1>least a couple of decades. In an effort to improve

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<v Speaker 1>postoperative outcomes of patients, a group of general physicians from

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<v Speaker 1>Europe developed a method called Enhanced Recovery after Surgery. It

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<v Speaker 1>employs practices designed to reduce a patient's hospital stay, complication rates,

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<v Speaker 1>recovery period, and economic costs. Through the years, the protocol

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<v Speaker 1>has evolved to include practices such as patient and family education,

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<v Speaker 1>pain management, and nutrition recommendations for the article this episode

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<v Speaker 1>is based on how Stuff Work. Spoke with Katie Starr

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<v Speaker 1>v VO, chief Scientific Officer with a v A Perioperative

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<v Speaker 1>Optimization of Senior Health at the Durham v A Medical

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<v Speaker 1>Center in Durham, North Carolina. She said, what we want

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<v Speaker 1>to do with prehab is bump somebody's baseline from where

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<v Speaker 1>they started so that we can delay and reduce the

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<v Speaker 1>loss and impact caused by surgery, so they'll be able

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<v Speaker 1>to recover sooner. The type of surgery and the patient's

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<v Speaker 1>needs dictate the type of prehab needed. For example, prehab

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<v Speaker 1>is often used in patients undergoing joint replacement surgery to

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<v Speaker 1>build muscle mass in order to better support the body

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<v Speaker 1>and provide mobility as the affected area recovers. So before

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<v Speaker 1>knee replacement surgery, prehab might be used to strengthen the

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<v Speaker 1>patient's upper body. It may focus on their arm strength

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<v Speaker 1>so the patient can lift themselves in and out of

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<v Speaker 1>chairs in their bed until it's safe to apply pressure

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<v Speaker 1>to the rebuilt knee. There's also cardio respiratory prehab. A

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<v Speaker 1>Star explained cardio respiratory muscles are extremely important when it

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<v Speaker 1>comes to intubation during anesthesia, the impact on the lungs

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<v Speaker 1>is very big. Strength training for those muscles and building

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<v Speaker 1>aerobic capacity can help improve cardio respiratory fitness, which helps

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<v Speaker 1>lessen the risk of infection, pneumonia, or aspiration after surgery,

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<v Speaker 1>all of which can cause long term complications. Meanwhile, nutrition

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<v Speaker 1>impacts how quickly the body heals from the stress of surgery,

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<v Speaker 1>which is why being nutritionally fit before undergoing surgery is

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<v Speaker 1>imperative to a good recovery. STAR set many conditions can

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<v Speaker 1>adversely impact nutrition. As we age, our bodies go through

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<v Speaker 1>physiological and metabolic changes that result in a loss of

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<v Speaker 1>muscle mass and renal function, which can affect hydration and

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<v Speaker 1>fluid status. Surgical stress also boosts blood sugar levels in

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<v Speaker 1>the body, opposing risks for patients who have diabetes, including

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<v Speaker 1>wound site infections and longer recovery. Cancer and cancer treatments

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<v Speaker 1>can also affect the person's ability to eat food or

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<v Speaker 1>absorb nutrients, which can lead to malnutrition. A Star said,

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<v Speaker 1>just like with function and cardio respiratory and physical function,

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<v Speaker 1>we know that nutritional status is going to decline in

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<v Speaker 1>the hospital setting. We want to make sure we do

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<v Speaker 1>everything we can on the front end to help mitigate

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<v Speaker 1>that on the back end. While anyone would benefit from

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<v Speaker 1>getting in optimal health before elective surgery, prehab is intended

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<v Speaker 1>for patient populations who are more vulnerable to surgical stress response,

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<v Speaker 1>including elderly people, anyone with pre existing conditions like diabetes

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<v Speaker 1>or autoimmune disorders, and patients with cancer, particularly those who

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<v Speaker 1>have undergone chemotherapy or radiation treatment. Star said, we're trying

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<v Speaker 1>to reduce the insult caused by surgery and get patients

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<v Speaker 1>home and back active and back to their baseline as

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<v Speaker 1>soon as possible. A prehab isn't a magic wand surgery

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<v Speaker 1>is always hard on the body and you have to

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<v Speaker 1>put in the work. But studies have shown enough evidence

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<v Speaker 1>to support the benefits of prehabilitation that the American College

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<v Speaker 1>of Surgeons has launched a program called it Strong for Surgery,

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<v Speaker 1>focused on identifying and evaluating evidence based practices aimed at

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<v Speaker 1>optimizing the health of patients before they go under the knife.

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<v Speaker 1>As always, I'm not a medical expert, so if you

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<v Speaker 1>are someone you love is preparing for surgery and is

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<v Speaker 1>curious about prehab, talked to an actual medical expert like

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<v Speaker 1>your doctor. Today's episode is based on the article prehab

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<v Speaker 1>could make your recovery from surgery a bit Easier on

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<v Speaker 1>how staff works dot com, written by Jennifer Walker. Journey

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<v Speaker 1>Brainstuff is production of I Heart Radio in partnership with

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<v Speaker 1>how stuff Works dot Com, and it's produced by Tyler Klang.

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<v Speaker 1>Four more podcasts from my Heart Radio, visit the I

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