Prehabilitation for surgical patients: a systematic review protocol

Abstract

Review question/objective The objectives of this review are to identify the impact of prehabilitation on postoperative outcomes. More specifically, the objectives are to identify: the impact of prehabilitation on post-operative functional status; the impact of prehabilitation on post-operative healthcare utilization (HCU) such as readmission, and/or utilization of acute rehabilitation service; the impact of prehabilitation on post-operative health-related quality of life (HRQL); and the impact of prehabilitation on post-operative pain. Inclusion criteria Types of participants This review will include studies that include adult patients (18 years and older) undergoing surgery in hospitals with the exception of day surgery patients. Types of intervention(s)/phenomena of interest This review will include any preoperative exercise interventions identified as a part of a prehabilitation program or preoperative exercises program in a study comparing it to ‘usual care’. Studies that compare the effectiveness of different prehabilitation programs such as home-based versus hospital-based prehabilitation, or aerobic exercise versus weight training will not be included in this review. Types of outcomes This review will explore the following post-operative outcomes: Primary outcomes: physical functional performance preferably measured by a validated tool such as the Timed Up and Go Test , 6-Minute Walk Test, Barthel Index, or Katz ADL. Secondary outcomes: healthcare utilization in terms of readmission, admission to acute rehabilitation; HRQL; and postoperative pain.