The Impact of Prehabilitation on Postoperative Functional Status, Healthcare Utilization, Pain, and Quality of Life: A Systematic Review

BACKGROUND: "Preoperative rehabilitation" or prehabilitation has been increasingly studied alongside the deleterious effects of surgery and functional decline. Prehabilitation is the preoperative optimization of physical functionality to enable the individual to maintain a normal level of function during and after surgery. This systematic review evaluates the effectiveness of prehabilitation on functional status, healthcare utilization, quality of life, and pain postoperatively. METHODS: Trials registries and databases of published and unpublished literature were extensively searched. All studies were assessed independently for relevance, eligibility, and quality. Seventeen studies were included in the review: 13 in orthopaedics (mainly knee or hip arthroplasty for osteoarthritis), 2 in abdominal surgery, and 2 in cardiac surgery. FINDINGS: There is no evidence to show that prehabilitation has signifi cant benefi ts in function, quality of life, and pain; however, it may reduce admission to rehabilitation after knee or hip arthroplasty for osteoarthritis. There is insuffi cient evidence to make inferences in other surgical populations, notwithstanding initial evidence does not demonstrate advantages.