British fitness coach Joe Wicks has partnered up with the Guy’s and St Thomas’ NHS Foundation Trust to help encourage elderly patients to get fit for surgery.
The fitness star has uploaded two prehabilitation exercise tutorial videos on his The Body Coach YouTube channel, which have been designed to help increase physical activity particularly among older people.
Experts hope that these videos will also help people recover faster after pre-planned operations.
But what does prehabilitation involve? And why is it important?
What is prehabilitation?
“Prehabilitation is all about getting your body and mind ready for surgery so that you’re getting the best possible outcome from any operation that you might be having,” explains professor Jugdeep Dhesi, consultant geriatrician at Guy’s and St Thomas’ NHS Foundation Trust.
What does this include?
The NHS takes a holistic approach to prehabilitation by looking at a patient’s lifestyle habits, and then identifies any potential risk factors.
“Prehabilitation includes things like discussing smoking cessation and alcohol intake, and trying to help people reduce their intake to the usual recommendations,” says Dhesi.
A patient’s level of physical activity is also looked at.
“One third of our population do not undertake regular physical activity, and this increases to two-thirds of those in the over-65 bracket,” highlights Dhesi. “This is especially important, as many operations are undertaken in older people, and two-thirds of our hospitals beds are occupied by those aged over 65.
“So, it’s important to be active before an operation so that we can get the heart and lungs working properly, which can improve outcomes after surgery.”
Existing health conditions are also taken into account.
“For example, things like diabetes puts people at a higher risk of a worse outcome after surgery,” recognises Dhesi. “So does high blood pressure, therefore these are the kinds of medical problems that we identify to improve as much as possible, so that then we can have fewer complications after an operation.”
How early should people start thinking about prehabilitation?
Start thinking about lifestyle changes as early as possible.
“Going to see your GP about something that you might need surgery for is the time to start to think about prehabilitation, so that you’ve got that head-start in terms of getting yourself as fit as possible for any treatment that you might have,” suggests Dhesi.
“But, we know that even if you end up doing prehabilitation even two weeks before an operation, it still can make a difference to your outcome.”
What type of exercise is recommended?
“Programs will vary according to how active you are beforehand,” emphasises Dhesi. “For people who are not even walking around for more than 30 minutes a day, three times a week, it’s about getting them to do some walking, going up and down the stairs, popping out to the corner shop, and increasing their physical activity.”
However, if people are already doing some exercise, then their prehabilitation plan might focus on activity to help their heart and lungs to function better.
“So, things like cardio respiratory exercise, but also muscle strengthening as well,” says Dhesi.”It’s all about doing things at the right level for yourself and then gradually building that up.”
What else should people think about before having surgery?
Nutrition
“Nutrition is really important. Thinking about the kinds of foods that you ought to be eating to get as much nutrition whilst not adding extra weight,” says Dhesi. “So, a healthy, balanced diet with a focus on fruit and vegetables, and lots of fibre.
“These kinds of things are key in the surgical setting, as much as they are for your general wellbeing.”
Practical preparations
“Set things up at home as well as possible, so that when you get home after an operation you’re able to have food in the freezer and have your room set up in a way that works for you afterwards,” advises Dhesi. “And talk to your family and friends to see who would be able to help you when you get home with any of the smaller tasks that you might need support with.”
The NHS also offers surgery schools where patients can meet other people who are about to have a similar operation.
“Go to any of the appointments that you’re offered before an operation, like the surgery schools, where you can talk through how people are preparing mentally, physically and practically,” recommends Dhesi.
Mental preparations
“Talk to your friends and family about things that you’re anxious about so they can think about ways in which they can support you after an operation,” advises Dhesi. “Also, go to your appointments with a list of questions.
“Don’t feel embarrassed about asking the kinds of questions that matter to you. Come prepared with your questions and then we can help to answer those.”
