Feasibility and effectiveness of exercise-based prehabilitation in patients opting for elective abdominal surgeries: A pre-post study

Abstract

Background: Surgical procedures are accompanied by various complications such as decreased respiratory muscle strength, decreased functional capacity, decreased quality of life, and increased the length of hospital stay. There is a growing body of evidence that indicates that exercise-based prehabilitation offered before major abdominal surgeries can improve the above-mentioned complications. Considering the socioeconomic inequalities, educational characteristics, and healthcare system, which are different in low and lower-middle income countries, it is important to know whether interventions such as prehabilitation are feasible and effective in patients undergoing elective abdominal surgeries. Hence, we set out to determine the role of exercise-based prehabilitation in patients opting for these surgeries. Methods: In this feasibility study, 71% of the eligible patients agreed to participate. Baseline values of respiratory muscle strength, functional capacity and quality of life were recorded preoperatively, and an exercise-based prehabilitation programme consisting of chest physiotherapy, aerobic exercises and inspiratory muscle training according to the patient’s capacity was administered until the day of surgery. A total of 62% of the participants completed the study whose postoperative values and a user satisfaction scale were noted. The feasibility parameters of recruitment rate, dropout rates, adherence events, adverse events and participants satisfaction were evaluated and the differences in the preoperative and postoperative values of respiratory muscle strength, functional capacity and quality of life were calculated using the paired t-test accordingly. Results: Feasibility was measured using five parameters. All the values were > 50% and above. The secondary variables respiratory muscle strength, functional capacity, and quality of life were not significant. Conclusions: This study concluded that prehabilitation is feasible and can be effectively delivered to patients scheduled for elective abdominal surgery. Clinical Trials Registry India registration: CTRI/2021/05/033707 (20/05/2021).